Simplifying the workers comp claim process

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Making life easier for you and the claim adjusters.

Workers comp claims accounts come in all shapes and sizes, and adjusters are faced with a broad range of different types of circumstances that require their attention and handling.

There is no perfect claim, but there are many things that can make life a lot easier for everyone.

Use the following to help to create a workers comp claim that will cause the least amount of grief and reduce processing time as much as possible:

• Make sure that the main contact for the claim is involved in the situation. This is because the primary contact will be called, and it is important that he or she be an individual who will have all of the facts and information available for the adjuster.

• The primary contact should be prepared for the call. That way, when the adjuster does phone, then he or she will have the information ready so that it can be shared with the adjuster. This could include information that will need to be sent from the personnel file, or wage records, details about the injury, and any information from witnesses such as their statements (which should already have been taken).

• The main contact should respond within a timely manner. Making the adjuster leave messages, send emails, and wait for a long time will only make things worse. The key to a successful and easy claim is to get back to the adjuster as soon as possible, within a reasonable amount of time, preferably within the same day, but ideally within the hour. Until the adjuster has the information for which he or she is calling, the claim cannot move ahead.

• The employer has a specific medical clinic or doctor that provides the injured workers with treatment. It makes the process more complicated when employees go to their own doctors to have their injuries treated. It also creates an air of suspicion, as that doctor is likely unknown to the employer and the adjuster. It makes things more simple if there is an occupational clinic that must be used for these claims.

• The medical clinic should be familiar with the employer and what options are available for light duty for the workers. This gives the doctor the opportunity to suggest alternative tasks for the employee instead of taking him or her out of the workplace altogether and improves the workers comp claim significantly.

 

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