Overview of Key Injury Management Roles and Responsibilities

If you leave the management of the workers compensation claims to chance, the chances are you will not have good results.  To have good results in the control of the workers comp claims, it is important that everyone involved – the workers compensation claim coordinator, the floor or field supervisors, mid-management, medical personnel, legal, senior management and even the employees know what roles and responsibilities are in the management of the workers comp claims. My theme is: Take Control.   Start by assigning roles and responsibilities to one or more parties in the process – it is a step that can be taken to get things on track. You don't need to assign ALL roles immediately, just take it one step at a time is enough.

2- Providing all new hires and providing annually to current employees the employee brochure on what to do in case of an accident

3- Arranging immediate medical care at the required medical provider or at the recommended medical provider

4- Providing the medical provider with a detailed job description prior to the employee arriving for the initial medical treatment

5- Interviewing the injury employee to obtain a detailed description of how the injury occurred.

6- Interviewing the employee's supervisor to verify the description of the accident and what could have been done to prevent the accident from occurring.

7- Completing the First Report of Injury and providing it to the claims office on the day of the injury

8- Contacting the employee immediately following the initial medical treatment for the diagnosis, prognosis and expected period of disability, if any

9- Arranging for light duty / transitional duty / modified duty for the injured employee

10- Sending the employee a get well card when the employee will be off work

11- Maintaining weekly telephone contact with the employee while the employee is treating weekly and telephone contact following each medical visit thereafter.

12- Facilitating on-going contact with the claims adjuster and the nurse case manager.

13- Coordinating and completing all necessary paper work related to the claim.

The employee's supervisor has pre-accident responsibilities to ensure all employees work in a safe and prudent manner. 

Post-accident responsibilities of the supervisor 

1- Accompanying the injured employee to the required or recommended medical provider.

2- Providing the medical provider with the Work Ability Form and obtaining the completed form from the medical provider's office

3- Submitting the Work Ability Form, the Supervisor's Report of Accident, the Employee Report of Injury and the Witness Report Form to the workers compensation claims coordinator.

4- Enforcing compliance with the transitional duty program and verifying the work done by employees on modified duty is in accordance to the medical provider's limitations.

5- Training all his/her employees on what to do in case of an injury.
 

2- Participate in the return-to-work transitional duty program

3- Attend all employee weekly meetings/office meetings unless physically unable to get to the work-site

4- Provide the Work Ability Form to the supervisor or claims coordinator after each doctor's visit.

1- Providing a strong safety program and implementing the necessary risk management practices to keep as many workers comp claims from occurring as possible.

2- Knowing the monthly and on-going cost of workers compensation.

3- Communicating to the employees how many additional sales or additional production is necessary to cover the cost of workers compensation claims.

4- Determining the medical providers that will be used

5- Determining the insurance carrier or the third party administrator.

6- Tracking and reporting loss work days.

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