Workers' Comp: What Should You Do When an Employee Gets Injured?
Your company probably does all it can to protect workers from getting injured. But odds are good that regardless of what you do to create a safe work environment, at least one employee will, at some point, report a work-related injury or illness.
Most states require employers to purchase workers' compensation insurance to cover the costs associated with such injuries, but the rules vary. Florida, North Carolina, and Wisconsin, for example, exempt companies with only a few employees from their coverage rules. (The National Federal of Independent Business did a state-by-state breakdown of workers' compensation laws, though you can find the most up-to-date information on your state's workers' compensation website.)
Beyond their coverage laws, many states also require employers to post details about their workers' compensation coverage — including the name and contact information of the insurance company — and information about what to do when an injury occurs. Employers are also often required by state law to document all reported workplace injuries and illnesses. The federal Occupational Safety and Health Administration (OSHA) requires many employers with more than 10 employees to keep a log of injuries and illnesses.
Even if your company isn't legally required to have workers' comp coverage, you should seriously consider it. It can help protect employers against the risk of an employee getting injured on the job and suing the business. Workers' compensation is designed to be a "no fault" system, meaning that employees generally cannot sue over a work-related injury or illness if their employer has coverage. The insurance will cover the healthcare costs and rehabilitation services the employee needs due to the injury, as well as provide replacement income for any necessary time off for recovery — assuming the insurer determines the claim is warranted.
So, what do you do once a worker reports a work-related injury or illness? Here are key steps:
Provide immediate treatment, if needed. It may seem obvious, but if an employee was just injured, the employer is responsible for getting them immediate medical treatment, whether that involves calling an ambulance, bringing them to a doctor, or treating the injury on site.
Give the employee a claim form quickly. State laws typically require that employers give an employee the workers' comp claim form within 24 hours of being notified of an injury. You also typically must give the employee written information about his or her rights under the workers' compensation system (such as a pamphlet) and details about the benefits available and how to file a claim.
Report the injury to the insurer and the local compensation board. Laws also typically require employers to report all injuries alleged by an employee within a few days in what's called a First Report of Injury document. Insurers typically want to see this document before they will consider the employee's claim.
Record all details. In order to comply with recordkeeping rules and to provide the necessary information to the workers' compensation board and the insurer, it's important to document all pertinent information about the employee's injury claim. This includes where, when, and how the injury occurred, and whether any other employees witnessed it. Keep in mind, that depending on the facts of the injury claim, the employee might be eligible for FMLA or state mandated medical leave.
Cooperate with the insurer. The insurance company's adjuster will likely want to investigate the claim; asking you questions about the employee's injury. They may also request certain documentation from you. Depending on the extent of the investigation, they may even want to visit the worksite and conduct a recorded interview with you or the employee's direct supervisor. It's important to cooperate to ensure the insurance company can collect the information it needs to do a thorough and accurate investigation.
Help the employee transition back to work. The faster and easier an injured employee's recovery, the sooner he or she can return to work—and the less workers' compensation will likely need to be paid. Stay in touch with the employee during the recovery process and consider providing guidance — if welcomed — in navigating the healthcare and rehabilitation services. Employers may be able to allow the injured employee return to work sooner by offering modified work tasks that the employee can do that don't involve tasks the employee can't currently perform due to their injury.
Keep in mind that workers' compensation laws are designed to protect workers and employers in case of work-related injuries — as they are often the only way workers can be compensated for the costs involved with injuries in the workplace. As such, employers are wise to embrace the system and refrain from discouraging employees from filing claims when work-related injuries or illnesses occur.
Workers' compensation insurance is mandatory in most states
Set up and manage the right policy with Paychex Insurance Agency to help you comply with regulations and stabilize your cash flow.