When one of your employees is injured on the job, it sets off a sequence of procedures that must be adhered to in order to protect your business. If a claim is filed--whether compensable or contested—it is imperative that you have the necessary documents on file. Documentation for workers compensation insurance becomes particularly crucial with contested claims, as these documents become the lynchpin for a solid defense.
Start Documenting Workers Comp Claims Immediately
Documentation begins as soon as the compensation claim is received. An early intervention process allows for a claims expert to properly document pertinent information associated with the accident while the critical details are still fresh in the minds of the injured employee and anyone else involved.
Early workers comp insurance documentation has another advantage: often, the employee is still working, which allows unrestricted access to the worker before representation. This can lead to evidence that would be harder to uncover once a lawyer is involved.
Other reasons for early documentation include:
- The injured worker and witnesses might change their stories if given the time
- Physical evidence can change or disappear
- Opportunities for research may be lost
- Proof of fraud or malingering may be missed
- Independent medical opinions may be jeopardized
- Symptoms are often exaggerated after a lawyer enters the picture
In addition, late documentation can damage an employer’s credibility and will sometimes lead to additional claims including harassment and discrimination.
Be Thorough in Collecting Evidence for Workers Comp Insurance Claims
It is worth noting that documentation of non-industrial injuries, tardiness, warnings, write-ups, and other personnel actions help to show the injured employee in a different light prior to litigation. Employers should be vigilant about maintaining proper WC documentation in the employee’s personnel file. This can be helpful in constructing an accurate portrayal of the worker before and after the injury.
Other workers comp documents that must be on file include…
- A comprehensive statement of the facts of the accident
- Witness statements, taken as early as possible
- Medical evidence obtained prior to litigation identifying the injury and body part
- Past medical records that are pertinent to the claim
- Independent medical examinations
- Personal and physical background information on the claimant
- Past claim records
- Photos and videos of the accident site
- Information procured from private investigators
- Copies of training programs and the employee’s participation in them
- Reports from professional experts and technical advisers
- A record of all telephone discussions with anyone connected with the claim
- A log of all employees’ functions from an up-to-date job description of all positions, especially modified duties
Medical Evidence is Key to a Workers Compensation Insuance Claim
While not every insurance claim will require this level of documentation, claim technicians will need many or all of these documents in some difficult cases. Many factors can affect the outcome of these cases. Experts seem to agree, however, that nothing is more important than medical evidence, procured prior to litigation, which identifies the injury or body part with a fair description of symptoms. Witness statements are also important, but witnesses have unreliable memories and are prone to leading questions. These factors lead back to the importance of early documentation.
Documenting a worker’s compensation claim is complex and time-consuming. But it is worth the hard work if it becomes necessary to defend a claim. Courts appreciate when complete and well organized paperwork is presented at a hearing.
Obtaining the Right Workers Compensation Insurance
Click here to contact us or give us a call at (800) 947-1270 or (610) 775-3848 to learn more about worker’s compensation and all of your insurance options. We'll help you choose the right policy and ensure you get a great deal because as indepenent agents we're free to shop among many competing workers comp insurance providers. Call or click today to get started.
