Question

What are the steps an injured worker has to take once an injury occurs on the job? What are some of the critical data elements that must be collected on a work comp claim in order to be reimbursed?

Answer 1

Some of the steps that need to be taken when an injury occurs on the job are-

• The very first step would be inform the concern authorities at work. If this is not done, there are chances that the company/employer might deny the claim of injury due to work.
• If the injury has lead to bleeding, kindly apply first aid which would basically involve cleaning the wound/cut/bruise with a clean cloth, and applying pressure with the help of cotton to decrease the bleeding. Depending the nature of the injury some precautions need to be taken before the patient goes to the healthcare provider which is solely dependent on the first aid knowledge of the patient and those around him/her
• Go to the nearest healthcare provider or if theres any one specific healthcare organisation that the company patient works with has tied up with.
• Inform the Physician that the injury is work related and the nature of work that the patient does for the physician to have a better understanding.
• Once all the medical procedures have been done, a report of the case history, diagnosis, treatment plan and the treatment done has to be taken from the hospital/healthcare provider for it to be submitted to the concern authorities at work. This would also include treatment summary. Usually healthcare providers have forms that they fill up, which can be submitted. Request for the same. The form numbers vary depending on the states of USA.
• Maintain a record of all the missed working days as well as out of pocket healthcare expenditures including travel. A fixed number of days are given for injuries of such nature by the company. Again, This also needs to be filled in a form, the number of which may vary depending on the state one lives in, in the USA.
• If the reimbursement procedure seems too cumbersome and confusing, one can hire an attorney. Insurance companies often use various tactics to deny and falsify the claims.