Accidents happen. Regardless of your best laid plans, claims will occur. As a business leader, how you react to and handle them can go a long way when it comes to possible outcomes.
What is Early Claim Intervention?
Simply put, it’s the act of getting involved early in the Workers’ Compensation process to dictate action and positively impact outcomes. The objective is to identify and plan strategies to overcome hurdles that can hinder an employee’s recovery from an injury. While early intervention is important in any industry or scenario, it’s especially crucial with Workers’ Compensation claims.
Typical Lifecycle of a Claim
Below is a list of steps outlining how the claims process typically works when it comes to Workers’ Compensation.
- The injury occurs and is reported to the supervisor or Human Resources (HR).
- Don’t wait to report! Delayed reporting has effects both monetarily and mentally. It can also impact your entire claim investigation.
- Gather facts and start documentation immediately.
- This sets things up better for the adjuster. This is when you might fill out a First Report of Injury (FROI) form.
- The supervisor or HR submits/files the claim to the Work Comp. carrier.
- The claim is logged and assigned to an adjuster.
- The adjuster reviews the First Report of Injury (FROI) and then determines if it is:
- Lost Time
- Medical Only
- Incident Only
- Inquiries begin.
- The claims adjuster contacts the employee, the employer, witnesses, and a medical provider to confirm compensation and possible disability.
- Efforts are made to preserve evidence.
- Work Comp. carrier determines if a claim is accepted or denied.
- If accepted, the Work Comp. carrier ensures the claimant has appropriate medical care, benefits are paid to the claimant, and medical care is monitored.
- Work Comp. carrier sends out notification to employer and employee once claimant is released from care by their medical provider.
How Expensive Are Claims to the Bottom Line?
Source: National Safety Council
Work Injury Costs – 2023
Total work injury cost in 2023 = $176.5 billion
Work injury cost per worker = $1,080
Work injury cost per death = $1,460,000
Work injury cost per medically consulted injury = $43,000
The true cost to the nation, employers, and individuals of work-related deaths and injuries is much greater than the cost of workers’ compensation insurance alone. The figures above show National Safety Council estimates of the total economic costs of work-related deaths and injuries.
Time Lost Due to Work-Related Injuries – 2023
Total days lost in 2023 = 103,000,000
Days lost due to injuries in 2023 = 70,000,000
Days lost due to injuries in prior years = 33,000,000
Days lost in future years from 2023 injuries = 55,000,000
Days lost estimates do not include time lost by people with non-disabling injuries or other people directly or indirectly involved in the incidents.
Early Intervention Tips
- Have an organizational claim reporting procedure.
- Create a culture of reporting and promptness. Make sure your team knows what to do if they are injured on the job.
- A study by the NCCI showed that delayed reporting can increase Workers’ Compensation claims costs up to 51%. Intervene early!
- Use a lens of empathy with employees who present a work injury.
- Your team just wants to be heard and understood. Litigation can become more common if you diminish the seriousness of injuries at work.
- 3 to 10 percent of all workers with injuries may experience delayed recovery related to behavioral health issues (WCRI). Watch for signs in your employees, and offer them a support system.
- Prioritize open communication with all parties.
- Injured worker: Don’t fear conversations because they are awkward or time-consuming. They are important! Don’t let your employees feel isolated.
- Treating physician: Make sure you understand the treatment plan from the treating physician. As an employer in Iowa, you have the ability to direct their care. Clear communication and open dialogue are key, so it’s best to use a physician with whom you have a previous rapport. This may allow you to be more aware of what the physician’s goals are. Additionally, be sure to let the physician know what the job duties and functions of the injured worker are.
- Adjuster: Keep the adjuster up to date on all processes.
If you’re a client of The Accel Group, our internal Claims team is like an extra advocate for you. Our team members have a combined 45+ years of experience, with many of them holding several designations and certifications. One of our Claims team members is also a licensed attorney. Additionally, they all bring unique strengths to the team and come from many different backgrounds, including safety training, bodily injury claims, complex coverage, litigated claims, liability investigations, property and commercial claims, and more.
In the end, early claim intervention is about protecting both your people and your business. By reporting injuries promptly, gathering accurate information, maintaining open communication, and approaching claims with empathy, leaders can help employees recover faster while reducing costs and disruptions. With the rising financial and operational impact of workplace injuries, proactive involvement in the Workers’ Compensation process is one of the most effective strategies!
Interested in talking with a member of our team? Get a quote for commercial insurance.