Workers’ compensation is designed to help workers who are injured on the job. When an employee files a workers’ compensation claim, the responsibility for moving the process forward is shared between the employer and the injured employee. To ensure a smooth claims process for all involved, you’ll each have a respective list of duties.
As an employer, you are responsible for preventative measures within the company as well as certain components of claim filing. Responsibilities you have when a workers’ compensation claim is filed include:
• Providing a safe work environment: As an employer, you are responsible for providing a safe working environment for all of your employees. You must take the necessary steps to prevent injury and unnecessary exposure to danger.
• Filing a First Report of Injury: If an employee is injured on the job, you must complete and file a First Report of Injury or an equivalent document. Be sure to forward the document to your workers’ compensation carrier.
• Respecting employees’ rights: When your employee is injured, you must take care to not violate any of that individual’s rights or related laws. For example, if your employee requires medical attention, you must allow them to see a doctor even if they are on the clock.
• Cooperating with investigative parties: In the aftermath of an employee injury, your workers’ compensation carrier and the employee’s attorneys may investigate the matter. You are required to cooperate with these investigating parties and possibly provide documentation, like payroll history or the employee’s personnel file.
• Allowing recovered employees to resume their positions: Once your employee makes a full recovery, you must allow them to resume working. You cannot fire or penalize your employees for their claims because this may subject you to criminal or civil charges.
• Cooperating with your state’s workers’ compensation board: You must assist your local workers’ compensation board in avoiding fraudulent or exaggerated claims. For example, failing to file the First Report of Injury may expose you to fraud liability.
While you must follow through on your end of the claim, the employee who’s been injured shares the responsibility of the claims process. If your employees are injured, they are responsible for these actions:
• Working responsibly: Employees must work responsibly, which means abiding by safety protocols. If your employee is found to be intoxicated at the time of injury, for example, he or she may forfeit workers’ compensation rights.
• Reporting the injury: While you are required to fill out and file a First Report of Injury, you can’t do so unless your employee alerts appropriate supervisors of the incident. Additionally, they should request a copy of the injury report and approve it for accuracy.
• Seeking medical attention immediately: If the employee needs medical attention, he or she is responsible for seeking out a doctor or treatment. If the employee fails to do so in a timely fashion, it may negatively impact workers’ compensation benefits.
• Maintaining accurate records: During the claims process, the employee should keep track of all important forms and correspondence from you, doctors, attorneys and workers’ compensation carriers.
• Cooperating with their insurance provider: The insurance company may request documentation from your employees or that they seek medical attention from an independent physician. Employees should comply with these requests.
• Acting responsibly after injury: Employees should follow doctor’s orders and manage their behavior after injury to ensure they heal as quickly and completely as possible. Some workers’ compensation carriers may hire private investigators to affirm the severity or presence of injury.
The specifics of workers’ compensation laws will vary depending on your state’s local regulations. While this guideline is an excellent start, you may want to consult with your state’s workers’ compensation claims procedures before moving forward.
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