Tips for effective injury prevention and claims management

In its 2014 Workplace Safety Index, Liberty Mutual estimated that employers pay just under $1 billion per week to injured employees and their medical care providers. Even one serious workplace injury may impact the bottom line of a small or mid-size business.

Employers that implement effective injury prevention programs may expect to significantly reduce the associated costs, including workers’ compensation payments, medical expenses, and lost productivity. Employers often find that process changes targeted at improving workplace safety and health benefit their organizations’ productivity and profitability.

Most successful injury and illness prevention programs include a similar set of common-sense elements that focus on finding all hazards in the workplace and developing a plan for preventing and controlling those hazards. Management leadership and active worker participation are essential to ensuring all hazards are identified and addressed. Workers need to be trained on how the program works, and the program should be periodically evaluated to identify areas for improvement.

According to the Occupational Safety and Health Administration (OSHA), the five basic elements of a successful injury and illness prevention program are:

  1. Management leadership
  2. Worker participation
  3. Hazard identification, assessment, prevention, and control
  4. Education and training
  5. Program evaluation and improvement

These features are common to almost all health and safety management programs. Each element is interdependent and important in ensuring the success of the overall program.

Correcting and preventing workplace hazards

Employers can help prevent workplace injuries and illnesses by looking at their workplace operations, establishing proper job procedures, and ensuring that all employees are trained.

One of the best ways to determine and establish appropriate work procedures is to conduct a job-hazard analysis. The analysis can be a valuable tool for training new employees in the steps required to perform their jobs safely.

For a job-hazard analysis to be effective, management must demonstrate its commitment to safety and health and follow through to correct any uncontrolled hazards that are identified. Otherwise, employees may hesitate to notify their supervisor when dangerous conditions threaten them because they do not believe management will take action.

In conducting a job-hazard analysis, according to OSHA guidelines, employers should ask the following questions about each job:

  • What can go wrong?
  • What are the consequences?
  • How could it arise?
  • What are other contributing factors?
  • How likely is it that the hazard will occur?

It is important to document the answers to these questions in a consistent manner. Describing a hazard in this way helps in your efforts to eliminate it and implement controls aimed at minimizing the risk of injury.

When an accident does occur

When an accident does occur, employers need to be aware of state laws with respect to reporting work injuries because failure to do so could result in a direct penalty to the employer, which is not covered by insurance. While most state laws do not require reporting to the state unless the disability extends beyond three days, employers should report all work injuries to their insurance carrier to ensure proper claims processing.

In Wisconsin, employers have seven days to report injuries that last longer than three days, while they have only one day to report injuries resulting in death.

For employers required to maintain an OSHA log, injuries must be recorded appropriately. OSHA regulations also require certain employers to investigate all workplace accidents. Even for those employers that are not subject to these OSHA regulations, investigations should take place within 24 hours of the incident. The investigation process can help employers detect fraud, provide documentation in the event of litigation, and prevent reoccurrences.

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To encourage timely reporting of an incident, employers should convey to employees the importance of reporting injuries immediately. Let employees know that prompt reporting allows for the timely payment of claims benefits — a key concern to injured employees.

Employers and employees must also understand that fast reporting ensures that appropriate medical treatment is delivered, which can prevent the injury from getting worse.

Communication with the claims adjuster and the employee

Beyond the legal aspects, employers should immediately identify any concerns or red flags. This should not be documented on the First Report of Injury because it is filed with the state and provided to the employee. As a best practice, employers should identify and communicate red flags as part of the initial investigation and reporting procedure and provide this information to the assigned claims adjuster. After all, it will not be nearly as beneficial for the carrier to learn about these red flags years or months later when a proper investigation can no longer be done and thousands of dollars have been paid. Employers should continue to report any red flags that occur over the duration of the claim.

Another best practice is to stay in touch with the employee. Plaintiff attorneys readily admit that employees seek representation when they feel unfairly treated or think the employer does not care about them. A “get well” card sent shortly after the injury and regular communication to check on the employee’s progress can go a long way toward showing the individual that he or she is valued. Studies show these small gestures have a monumental impact on returning employees to work and limiting litigation.

Thomas Boudreau is the Property & Casualty Practice group leader/VP in Wisconsin for Associated Financial Group.