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3:14:43 AM CDT
Sunday, August 31, 2014

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If You Have an Injured Employee

Timeframes for Reporting an Injury:

- WSI encourages injured employees and employers to immediately (within 24 hours of occurrence and after medical treatment is received) file a claim with WSI after a work-related injury occurs. Immediate notification allows for more effective management of the claim.

- The law requires that your employee notify you within 7 days after an accident or when the general nature of the injury becomes apparent. Within 7 days of receiving notice of an injury from your employee, you are required to file a claim with WSI. If you do not, WSI may consider that to be an admission that the alleged injury may be compensable.

Four Important Steps:

  1. Assist your employee in obtaining prompt medical care.
    - In an emergency – the employee should seek immediate medical care at the nearest emergency room and notify you as soon as possible thereafter.
    - In all other instances – the employee should inform you of the injury before seeking medical care. You should provide first aid on site, if necessary.
    At the initial medical treatment and during ongoing medical treatment, WSI encourages you to go with your worker when they seek medical care. While you do not necessarily have the right to be present in the examining room during the worker’s exam, you benefit by going along because you will better understand any work restrictions imposed by the doctor – which enables you to provide a safe return to work for your employee.
    If your company has selected a designated medical provider (DMP), workers are required to see your company’s designated medical provider (DMP) for medical care UNLESS they have previously informed you, in writing, of a different medical provider selection before any injury occurred. If a worker sees your company’s DMP, the employee may request to change providers after being treated for 60 days by the DMP.
    Require that the employee provide you with a Capability Assessment form (C3 form) after the initial medical treatment and after all ongoing medical treatment. The Doctor's Report of Injury should include the nature and extent of the injury, estimated course of recovery, and a return-to-work plan with identified restrictions, if any.

  2. File a claim with WSI immediately after a work-related injury occurs (within 24 hours of occurrence):
    Whichever claim filing method is used, complete the FROI form with your worker, if possible. No decision can be made on a claim until all required information is received. Explain workers’ compensation procedures to the worker and assist in relieving any anxieties they may have relating to the injury and their position.

  3. Conduct an investigation immediately while the information is fresh in people’s minds - then take the necessary corrective action to prevent the injury from happening again. Your written accident investigation report should include the following elements:
    • Inspection of the accident site.
    • A determination of the reasons why the incident happened.
    • The circumstances surrounding the incident.
    • Securing evidence and taking photographs.
    • Interviewing all witnesses and others in the accident area and writing down their statements. Interviews should be conducted in a sensitive manner at a comfortable location.
    • An outline of the necessary corrective action that will be taken to prevent the injury from happening again.

    If your company does not have a policy for injury reporting or guidelines for investigating workplace injuries, call our Loss Prevention Education Unit and we’ll help you develop them.

    If the investigation suggests that your employee's injury is not your responsibility or seems questionable in nature, be sure to write your comments on the FROI form. If you have already submitted the FROI form with the Employer Section completed, please write or call us with your concerns.

  4. Stay in contact with the worker, the medical provider, and WSI. Help the worker continue to feel that they are an important asset to you and your company.

Be involved in the medical care given to the employee and make contact with the medical provider. (A release of information should be signed by the employee if medical records are being requested from the medical provider.)

The Claims Process - What You Can Expect From Us:

  1. On potential wage-loss claims, a claims adjuster will contact your company’s claims coordinator to gather information to decide whether wage replacement benefits are appropriate - this includes verification of the worker’s current gross wages.
  2. Our claims adjuster will request your accident investigation report and any other information you want WSI to consider when reviewing the claim. Please remember you have firsthand information regarding the injury as this is your employee and your place of business.
  3. If your employee has not returned to work, you may be contacted by a return-to-work services provider who is trained to help you return your employee to work as safely and as soon as possible, making work a part of the recovery process.
  4. When a decision is made regarding claim acceptance or denial, you will receive written notification. Along with this notice, instructions will be provided for you to follow if you disagree with the decision.
  5. We will provide the employer with any information requested on the status of the claim and copies of documents from the claim file at any time.

Keeping a Claim and Medical Treatment on Track:

Keep in touch with the worker, as this will help them maintain a positive outlook - and assist in the recovery process. Contact the worker weekly to answer any questions.

Keeping in touch with the medical provider will allow better understanding of the worker’s condition and abilities. When the doctor says the worker is ready to return to work with medical restrictions imposed, help by making transitional work (modified or alternate job duties) available to the worker.

Please also promptly respond to any information requests you may receive from us as this helps us with the processing of the claim.

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