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Early reporting can help keep soft-tissue injuries from being hard on workers’ comp claims costs

August 14, 2018

Workplace injuries are traumatic for everyone involved. Is your organization aware of the benefits of timely reporting of injuries?

Vice President, Medical Management

Her areas of responsibility include Zurich Care Plus, Medical Bill Review, Medical Professional Case... About this expert

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For employees and their families, injuries mean coping with the inevitable discomfort of recovery and disruptions of normal routines. For employers, accidents mean the stress of immediate concern for the well-being of injured employees with the added dimension of likely reductions in continuity and productivity. In addition, employers face state reporting requirements that must be met when a worker is hurt, with the potential for litigation if reports are filed outside statutory reporting windows.

In the case of a broken bone or serious laceration, the need for immediate medical intervention and reporting is clear. However, the full dimensions of some workplace injuries may not be immediately apparent. Soft-tissue injuries such as muscle strains, sprains and tears, if not reported quickly and treated effectively after the precipitating event, can worsen over time and continue to cause discomfort and impaired function into the future. Hence, timely reporting of soft tissue injuries means earlier treatment and improved outcomes.

If an accident precipitating a soft-tissue injury occurred weeks in the past and was not reported to the insurer and appropriate regulatory agency until symptoms significantly worsen, the ultimate costs and complexity of a workers’ compensation case can balloon. Claims may even be challenged or denied by insurers and fines may be levied by regulators for inappropriate reporting lag times. Conversely, a 2015 report by the National Council on Compensation Insurance (NCCI) noted that among all workplace injury claims involving sprains, strains and contusions, those with the lowest median costs were reported within the first week of occurrence. Once an injury is reported and “in the system,” future developments can be addressed as they arise.

The science of predictive analytics demonstrates that early reporting reduces claims costs and results in better outcomes. Any workplace accident resulting in an injury requiring immediate medical attention should be reported as soon after the event as possible, within two weeks being ideal. However, accidents not involving fractures, lacerations or other immediately apparent injuries should not be shrugged off by the affected employee or the supervisor. Once again, soft-tissue injuries that do not instantly manifest symptoms may develop into costly claims at a later date.

Whatever form a workplace injury may take, the most effective way to emphasize early reporting is by creating a culture that understands the value of timely reporting. Consider implementing these simple workplace injury reporting best practices within your organization:

Pre-incident

  • Conduct annual training for employees and supervisors
  • Be familiar with state rules for “first aid” claims vs. claims subject to reporting
  • Establish and monitor reporting goals at the location level
  • Commit to modified return-to-work programs
  • Set expectations for supervisors to support return-to-work programs

Post-incident

  • Complete an internal incident investigation and post-incident drug test immediately
  • Report the claim within 0-3 days
  • Take advantage of your carrier’s medical management program; provide employees with medical provider information
  • Help employees understand the process and minimize uncertainty
  • Keep the conversation constructive – focus on what happened and future prevention, not blame

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