Understanding the Injury Process Can Help Ease The Pain When it Comes to Workers’ Comp

Chris Dik – V.P. Sales Management

We all hope that our employees never get injured on the job. But the truth is accidents do happen, and when they do you need to have a process in place for dealing with a workplace injury, so you aren’t caught off guard.

Every manager, supervisor, VP, and all other leaders in the company must know exactly what to do if someone gets injured. When it does happen, someone of authority should be notified to help direct the next steps. If the employee requires medical attention, this person should be able to make the decision, based on the type and extent of the injury, on where to go to get treatment, and accompany the employee to that location.

Companies with a streamlined internal claims process are in the best position to get their workers the care they need and get them back to work sooner. This process also helps companies protect themselves from the possibility of breaking important reporting regulations.

The injury process begins with first assessing the injury in order to determine if emergency care is required or if an urgent care center would be more appropriate. Think through the decision (but not too long) as automatically sending everyone to the emergency room, no matter the sever­ity of the injury, typically increases claims expenses by 30-40%, while not always pro­viding the best level of care. Emergency rooms are overrun by non-emergency pa­tients that delay proper care for everyone.

See page 3 to read the article on urgent care centers.

Utilizing a claims triage service can pro­vide multiple benefits for both employees and employers. For employees, it offers the appropriate and targeted care they need with less wait time (an obvious morale booster for anyone who has spent more than a few hours sitting in emergency room waiting areas). For employers, these servic­es reduce overall claim frequency, cut the costs associated with large claims, and re­duce the number of fraudulent claims.

A good injury process should contain a number of elements:

  1. The steps needed to get the injured employee to the appropriate care facility as quickly as possible, depending on the severity of the injury.
  2. Determining if additional medical care will be needed.
  3. Does the injured employee need time to rest and recover, or can he or she go right back to work?
  4. Upon returning to work, does the em­ployee require alternative work options for this type of injury?
  5. Make certain to focus on following up with the injured employee until they are healthy and fully recovered. Empathy is a critical element in your injury process. When an employee feels that no one cares about them and their injury, they are more likely to take a much slower path to recovery and returning to work. Management needs to express their interest in the employee’s well-being and ensure they are being cared for appropriately. Showing a level of concern may seem trivial, but it makes a substantial difference to the employee.

It is critical that you provide notification of any injury to anyone who requires this information. In most instances, your workers’ compensation insurance carrier will need to be notified directly. And, depending on the type and severity of the injury, there may also be OSHA requirements that you need to fulfill.

Internal notification is just as important as external notification, and there should be a clear path for your managers to follow. Typically, this should go right up the chain of command depending on the severity of the accident. The HR Department or risk safety manager should also be notified in all cases. For some employers, these roles may be filled by a single person wearing many hats or the roles may be spread out across the company. Every company is different so be clear who needs to be notified and document this as part of your process.

In most cases, a post-injury review should be conducted to determine if everything went as planned once you knew about the injury. Could the injury have been prevented? What actions should you take in order to prevent similar injuries? Do you need to make any changes to your existing injury process?

If you’re not sure where to start when it comes to creating your injury/claims process, let us know. We have extensive experience and the resources needed to assist businesses in setting up the all-important injury/claims process checklist.


Should you have any questions about this article – or any insurance matter – please feel free to contact me at CDik@KnightDik.com or call me at 508-753-6353 Ext. 112.

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