Employers should develop and facilitate training supervisors on when, where and how to report work-related injuries and illnesses. In accordance with the organization's policies and procedures, employees should be trained to report the incident to the company's designated representative this is usually someone in human resources, a manager, or a health and safety committee member. The representative should determine whether first aid is required and can be performed on the scene or if additional emergency care is required at a health care facility.
Depending on the severity of the injury, the representative may need to notify the employee's emergency contact of the incident.
The employer should take immediate action to ensure that the worksite where the incident occurred is safe and secure to prevent additional incidents.
The report usually requires the following information: date of injury, the place where it occurred, a description of the injury or illness, the date the employer became aware of the injury or illness, the date that the employee received the form, the date the employee returned the form to the employer, and any other required information. If the employee was given the report to complete, the representative should give the employee a deadline to complete it. If the employee needs to return the form via mail, the representative should direct him or her to mail it certified with a return receipt so there is a record of the date the employee returned it to the employer.
During the meeting, the representative should share with the employee the claims procedures, the benefits available to the employee and whom to contact for any concerns. Items frequently covered in this discussion include:. Next the organization files the incident report with the company's workers' compensation carrier.
Employers should check with their workers' compensation carrier for the available methods to submit the report. Some carriers prefer electronic submissions, whereas others prefer that employers use a telephone system. Some employers may also be required by state law to submit the report to the state's workers' compensation agency. Employers should check with their workers' compensation carrier because it may file the incident report for employers.
Organizations must maintain contact with the workers' compensation carrier on the employee's claim. The employer may need to forward medical documentation to the workers' compensation carrier. Moreover, the workers' compensation carrier may have documents for the employer to complete. These documents may request information such as the number of lost workdays, the employee's return-to-work status and any salary continuation to determine wage replacement benefits. The representative next informs the employee that the claim has been submitted and when to expect contact from the workers' compensation carrier regarding wage replacement and medical treatment.
The representative should then establish a schedule of regular follow-up on the employee's progress by telephone, mail or e-mail to let the employee know that his or her well-being and return to work are important to the organization.
Establishing a timeline for the employee's return to work is imperative, as is making the determination about potential restrictions that may require accommodation and whether the employer will be able to accommodate the employee's needs. The employer should have a policy in place that includes how leave interacts with workers' compensation.
Returning an employee back to work should be one of the main focuses for the employer, even if it is in a light duty capacity. The employer's policy should be a thoughtful, well-written document that can be administered with care, taking the employee's needs into consideration.
Some workers' compensation carriers have resources to assist employers with their return-to-work programs. An employee's return to work may have doctor-directed medical restrictions that may allow the employee to return on restricted or light duty, which is typically less physically and mentally demanding than the employee's normal job.
If the employee is eligible for FMLA leave, he or she can accept the light duty assignment, which will not count toward FMLA leave because the employee has returned to work and is no longer taking leave.
Alternatively, the employee can continue to be out on the available FMLA leave. The employer may not penalize or retaliate against the employee for opting to remain on FMLA leave.
However, the employer is allowed to restrict the employee from receiving wage replacement benefits through workers' compensation and short-term disability when the employee opts to take the leave instead of working, based on the doctor-directed medical restrictions. Making temporary accommodations to assist the employee in returning to work after an incident will be advantageous to the employee, making him or her feel connected to the organization and contributing to it.
As for the employer, making the accommodations can help reduce costs by decreasing the need for temporary help and overtime. The case may well need to proceed to court.
However, as previously stated, it may take more time before a claim is approved, especially when it gets to appeal. Perseverance in the face of adversity may be a noble virtue outside the workplace. The law has set limits on the length of time the injured workers must officially notify their company of work-related injuries. However, failure to formally report as required by law may be disastrous with far-reaching consequences.
The State of California, for instance, requires an injured worker to file a claim within a year of sustaining the injury. Missouri also requires an injured worker to notify their employer within 45 days of sustaining a work-related injury.
Were you injured in a work-related accident? Are you expecting to receive maximum compensation for your injuries? Is your employer or their insurance carrier denying your claim? At Rosenfeld Injury Lawyers, LLC, our accident injury attorneys can fight aggressively on your behalf so that you get the rightful compensation you deserve. Call our law firm at toll-free phone number or use the contact form today to schedule a free case evaluation.
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Medical Disability Benefit Medical disability benefits cover medical costs and expenses incurred on the injury sustained in the course of employment. The conditions for eligibility to receive disability benefits include: The injured worker is entitled to temporary total disability benefits when the disability injury sustained is for a relatively short time. Temporary partial disability benefits arise when workers sustain a mild injury that reduces productivity but is not life-threatening.
Medical professionals must declare injured workers as permanently having a disability and unable to work. In addition, a worker must be suffering from a very severe work injury to qualify. The employer must appear at a hearing if directed to testify by a judge. Return to Top. Toggle navigation. Workers' Comp Benefits. Home Compensation Benefits. Compensation Rates Compensation is based on earnings determined by payroll records for the 52 weeks prior to the date of accident.
Compensation may be withheld when lost time exceeds seven days, if: NYSIF received no medical evidence of a causally-related disability beyond seven days The employer is paying full wages In death cases, NYSIF is waiting for evidence of dependents who are entitled to benefits NYSIF is disputing the claim on behalf of the policyholder Forward all medical information from claimants to the case manager for consideration of benefits.
If NYSIF contests the claim, it must controvert the claim as follows: On or before the 18th day of disability event, or Within 10 days after the employer learns of the alleged accident, or Within 10 days after the carrier receives notice, whichever period is greater. Filing of the notice of controversy within 25 days of the notice of indexing will only preserve our right to raise issues of accident, accident arising out of and in the course of employment and employer-employee relationship.
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