As part of the WorkSAFE Webinar series, MEM recently hosted a seminar titled “Eyes on the Scene: Strategies to Improve Incident Investigations and Claims Outcomes” presented by Terri Sweeten, field services manager in the claims department at MEM.
Not able to tune in? Here are a few takeaways and best practices we covered. You can also view the recording of the event here:
When it comes to claims investigation, “there is no such thing as too much information,” said Sweeten. That’s why it’s important to have policies and procedures in place before an incident occurs and to understand what steps need to be taken afterward.
Session key takeaways:
Time matters in an investigation
- Stop and investigate: report the claim in a timely manner
- Use tools at your disposal to record key information such as using a cell phone to record video or take photos of where the injury occurred.
- Have a backup plan for after-hours injuries
- Communicate with employees about your expectations for injury reporting.
Understand crucial claim components
- Train staff on how to manage a work comp claim when it occurs.
- Know your statute of limitations on claims/injury reporting.
- Understand: was the employee qualified to perform the tasks?
Review key steps in the investigation process
- Before an incident occurs ensure you have written accident investigation procedures in place.
- Components of an accident reporting policy include: who to report to, when required, and when employees seek care
- Require all supervisors to participate and understand the value of procedures.
- Document properly: take photos of the scene and look for contributing factors.
Review case law in support of performing thorough and timely investigations
- The law states an injury must be the prevailing factor in a claim.
- Just being at work does not necessarily make an injury work related.
- Involvement of drugs and alcohol can reduce workers compensation and death benefits by 50%.