Injuries & Accidents on the Job:
Employer best practices for reporting and handling work comp claims

 

When an accident happens at work, employees and employers need to know their responsibility to report a claim.

Workers’ Compensation coverage protects both the employee and employer from the financial impact of a work-related injury or occupational disease.  It pays the injured employee for approved medical, hospital and related services. If temporarily unable to work, the employee can receive partial wage replacement payments.

Most Common Accidents in Restaurants

The National Institute of Occupational Safety and Health reports the most common accidents in restaurants include:

  • Lifting and repetitive motion
  • Slip and fall accidents
  • Cuts from sharp utensils and kitchen tools
  • Burn injuries caused by hot foods and drinks, deep fryers, stoves, ovens, and other appliances
  • Exposure to harmful chemicals
  • Excessive noise
  • Motor vehicle accidents while delivering food

Employer responsibilities when an employee is injured on the job

Before an accident occurs:

  1. Ensure that the Workers’ Compensation Laws and Regulations are posted in an area accessible to your employees. In some states, the panel list of medical providers is also required to be posted.
  2. First aid kits should be available in each location for minor injuries.
  3. Train managers on the importance of reporting claims promptly. Have written procedures on the process and assign a back-up contact in the event the manager is absent.
  4. Encourage employees to report all claims, even if they don’t think they are serious. Reassure employees that there are no negative repercussions for reporting a claim.

At the time an accident happens:

  1. If it is an emergency, seek immediate medical attention by calling an ambulance, or getting the employee to a hospital or an urgent care facility.
  2. Keep an accident log and complete an accident report even if it is a minor mishap. Minor accidents sometimes turn into injuries requiring medical attention.
  3. Provide transportation or emergency ambulance service, if needed.
  4. Make sure your injured employee immediately obtains required medical care from the doctor or hospital of their choice.
  • Injured workers should choose a health-care provider who is part of the Medical Provider Network (MPN) unless you are in a state in which the employee has the right to choose his medical provider.
  • In states in which the employer is allowed to use the Medical Provider Network, the employee may see a non-network provider for the initial visit, but for additional or ongoing care, they will need to transfer to a network provider. You can help your employee find a network provider from the panel list on the Medical Provider Network.
  1. File a claim by email or phone.
  • Answer all questions on the worker’s section of the Report of Accident if you are filing by email – to avoid a possible delay in benefit payments. If reporting the claim by phone, the claim representative will complete the first report of injury for you.
  • Your insurance provider should review the claims process with you and provide any required forms including the wage statement.

After the accident is reported:

  1. Submit an accurate wage statement and certain benefit information to be used to calculate time-loss compensation benefits for the injured employee. Verify your employee’s information, such as gross wages and hours worked.
  2. Insurance company will send the employer an “Employer Report of Industrial Injury or Occupational Disease Form”. This serves as your official notice that a claim for benefits has been filed by one of your employees.
  • If you question the validity of the claim, state it on the form and explain your reasons why. This will help minimize invalid claims.
  1. Comply with the investigation process by assisting with requested interviews and making available any witnesses to the accident.
  2. Call your employee right away to share your concern about the injury. Do what you can to get him or her back to work as soon as possible. Continued communication throughout the absence from work is important in the relationship with your employees showing they are valued and missed.
  3. Consider developing a plan for employees who are released for light duty due to restrictions. The health-care provider may limit work activities or reduce the number of hours your employee can work during recovery. Offering light-duty within those restrictions will get your employee back to work faster and reduce claim costs
  4. Immediately forward any state documents or legal demand to your insurance carrier, as response is time sensitive. If legal action is brought against you, your insurance company will retain an attorney to protect your interests.
  5. If someone not employed by you caused the accident, you should indicate this on the form. It is to your advantage to document the case and provide complete records of facts and all evidence surrounding the accident.
  6. Investigate any accident or “near miss.” The purpose is not to fix blame or deny benefits to anyone injured, but to determine what steps can be taken to avoid such incidents in the future.

Reporting all claims on time can provide an opportunity to investigate that particular accident and learning how you can prevent similar accidents in the future – which can help keep insurance costs down. Establish a company culture that emphasizes the need to report any and all claims promptly and that makes sure employees know they won’t be punished for doing so. This may take a while, but you will see positive results over time.

This material is for general informational purposes only, and while reasonable care has been utilized in compiling this information, no warranty or representation is made as to accuracy or completeness.  Distribution of this information does not constitute an assumption by us of your obligations to provide a safe workplace. Maintaining a safe workplace in accordance with all laws is your responsibility.

 

Insights for Safety is a program developed by Intrepid Direct Insurance, a Diamond Allied Partner of the Jimmy John’s Franchisee Association to educate and assist franchisees, their managers and their personnel.