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Claims Management

How to Develop a Post-Injury Response Procedure

Taking ownership and standardizing your organization’s post-injury procedure can assist in mitigating business interruption and ensuring your employees receive prompt medical attention. These steps can help streamline your process for efficiency and effectiveness.

October 9, 2023

Defining your post-injury procedure will be one of your first steps when making changes to your workers’ compensation program. When your organization owns this process, it creates a better cost-containment strategy. Rather than leaving the process entirely in the hands of the claims adjuster, your company can have a step-by-step process that it can follow to maximize outcomes.

“Determining what happens at the time of an injury, and immediately thereafter, will help you create systematic procedures to verify that no steps are missed throughout the process,” said Patricia Lewellen, Excess Workers’ Compensation Claims Manager at Safety National. “This will also typically include an incident analysis, which, when used appropriately, should identify the root cause of the incident and ways to prevent other potentially similar occurrences.”

Here we review how an effective post-injury response procedure may operate.

  1. Employee reports the injury to the supervisor immediately. No matter how slight.
  2. Supervisor reports the injury to Human Resources or the appropriate department.
  3. Supervisor or dedicated employee stays with the injured employee.
  4. Supervisor contacts the physician or clinic to advise them that the injured employee is on their way.
  5. Supervisor provides the injured employee with the following:
    • Workers’ compensation brochure – Covers basic questions and the process
    • Work ability form – Returned to the employer after medical treatment and will detail injury type, treatment, and potential job limitations
    • Additional state-required form(s) – Returned within a specified timeframe of the report of an injury. For example, California will require a DWC-1 form, which reports the injury to an employer and officially initiates the workers’ compensation process.
  6. Supervisor or dedicated employee accompanies the injured employee to the physician. The established employer policy on transporting injured employees to the physician should be followed.
  7. Employee takes the work ability form to the physician to complete at the first visit.
  8. Employee returns the work ability form to the supervisor after treatment.
  9. Supervisor initiates incident analysis procedures. A key aspect of incident analysis is to maintain an open-minded, non-judgmental mindset during all analysis and interview processes. Tips for the interviewing process include:
    • Asking open-ended questions that require the employee to explain the incident in their own words (i.e., do not ask questions that can be answered with a simple “yes” or “no”).
    • Conducting interview(s) in a non-intimidating environment.
    • Ensuring the interviewee understands the purpose of the interview helps to ultimately determine ways to prevent the incident from recurring.
    • Asking questions with the intention to learn lessons from the incident in order to prevent recurrence of similar incidents.
    • Asking for input and ideas from the interviewee on how to prevent recurrence of similar incidents.
    • Report only the facts as provided by the employee.
    • Document the interview, including the time and place of the interview.
  10. Supervisor ensures communication is open between the medical provider and the employee.
  11. Supervisor initiates follow-up communication and a return-to-work plan.

After you have designed and published your post-injury response procedures, ensure that the document is readily available. In the event of an injury, the supervisor or dedicated employee should be able to locate and reference it quickly and easily.