Claims Management 101: Four Steps to Remember if an Employee is Injured at Work

July 19, 2019

 

Despite everyone's best efforts, accidents can happen in any workplace. However, when an employee is injured, it is crucial to ensure the employee receives appropriate medical treatment and that the compensation claim is filed within the prescribed time limits. If you are unsure of the reporting time limits, refer to the WSIB/WCB/WorkSafe website for your province.  

 

These are the 4 main steps that can help you to manage your claims within the required reporting timeframes:

 

1. Plan Ahead 

  • Be prepared for the worst-case scenario.

  • Have an Accident Reporting Policy and System in place – include reporting requirements, roles and responsibilities, the investigation procedure, Return to Work Program.

  • Train supervisors and employees on your policies and programs.

  • Create a list of modified duties that are available in your workplace.

  • Keep Return to Work packages ready to provide to employees when needed.

 

2. Immediately Respond to a Report of Injury

  • Complete a thorough investigation of the accident – this is critical for the prevention of future accidents and to help you determine if the injury meets the criteria to be considered a reportable workplace injury. 

  • Offer suitable work in writing as soon as possible – you don’t have to wait until you receive the limitations from the doctor, instead use standard precautions. An employer can offer modified duties without medical information as long as it is reasonable. 

 

3. Complete the Required Paperwork within the Prescribed Timelines

  • Provide as much information as you can at the time of the initial report.

  • Note any concerns you may have with the claim, provide information about any prior related injuries or non-work-related pre-existing conditions, and if a third party may have been responsible for the injury.

  • Document everything – calls with the employee, compensation boards, meetings, etc. 

 

4. Follow Up

  • Remember that you are entitled to know about the employee’s prognosis (not diagnosis) and their functional abilities/restrictions. This information is crucial for a successful Return to Work Program.

  • Maintain communication with the injured worker throughout the claim.

  • Contact the compensation board if the employee is not cooperating in the process.

  • Request updates from the compensation board.

  • Keep an eye out for any red flags such as inconsistencies in reporting, prior medical issues, non-cooperation etc. Document and report all to the compensation board.

 

Overall, it is the responsibility of the employer to establish and communicate appropriate directives/instructions concerning the procedures for notification of occupational injuries or diseases. However, the better prepared you are, the less likely it is that a workplace injury will prove costly.

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