During the evaluation of injury claims made through workers comp, one must keep in mind that the worker’s comp insurance is purchased by the employer through a variety of insurance providers. After a claim is approved by the insurance company, they then begin to pay benefits to the employee.
Although this is the case most of the time, states create individual plans for worker´s comp that are used for regulating purposes, employee safety, and dispute resolution. It is for this reason that a lot of information concerning injuries takes place over a multitude of institutions.
In a 2020 report by the IJERPH, it was discovered that there were 5 main injuries that were reported to worker´s comp. These involved:
- A strain
- A Contusion
- A laceration
- A sprain
- A puncture
Below, we explain the top injuries reported to worker´s comp.
A Strain
When an individual experiences a strain, it is due to the muscle or tendon being overly stretched or tears. The majority of strain injury is caused by performing repetitive motions while working such as pulling, pushing, or lifting objects that weight a lot.
A Contusion
A contusion is the medical term for a bruise that results from any body part getting hit hard. Although a bruise is not considered to be a major injury or having much significance, it does have the possibility to cause a substantial amount of pain- For a bruise that becomes associated with swelling may be a sign of an issue that is more severe in nature.
A Laceration
When a laceration happens while working, it is usually caused by an employee handling the wrong type of tool or having no knowledge of how to handle the use of the tool. Any machine tools that have exposed blades or protective parts may also cause a laceration. By ensuring that lighting is good, you will decrease your chances for lacerations.
A Sprain
Equal to a strain injury, the sprain also happens due to overstretching or tearing of a ligament. Sprains are also the result of repetition and manipulating objects of significant weight. The individual may also experience a sprain if they become uncoordinated in their actions.
A Puncture
Employees can experience a puncture injury as they handle tools that are sharp. Some examples include scissors, knives, working on surfaces that are splintered, nails, or glass. Dull items or even shards made from glass or metal can put an employee at risk for a puncture would to occur.
Conclusion
Having an idea of what injuries are reported the most to worker´s comp can help an employer instill ways to make a work environment safer. To get a better idea of what you can expect from reporting an injury to worker´s comp, contact us today and we will be happy to assist.
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Posted on: Dec 23 2021
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By: admin
When it comes to reporting injuries in the workplace, it is preferred that they get reported shortly after occurring. The deadline to submit a worker´s comp claim will differ among each state. However, the normal timeframe seems to be ASAP, which is not a bad thing.
Having a flexible timeframe such as this can be justified by having some factors involved.
- Injury being deemed as work-related by a doctor
- Circumstances of the injury
- When the injury occurred
As far as the state that you live in is concerned, when an employee takes too long to report their injury, they may become ineligible for benefits or worse their benefit amount may be much less than it should be. A good example of this is in Colorado. For every day that reporting is late, you will be deducted an equal day.
Besides having the injury reported after the occurrence, an employee will need to file a claim for benefits if they choose to be compensated. All documents from a doctor will need to accompany the claim form when the employee makes the claim.
For filing a benefits claim for worker´s compensation, the timeframe can vary by state, but normally the variance can be more than 3 years. With that, it is also advisable to file a claim ASAP due to the amount of time the claim may need to be closed.
For instances where the employer declines to have the injury reported, then the employee has the right to make direct contact with the insurance provider to file their claim for benefits. If the insurance provider information is unknown, then the worker´s compensation for the state may be contacted to obtain the insurance provider information.
Timeframe For An Employer To Report Worker´s Comp Injuries
As an employer is notified of a work-related injury, they should work as a guide for their employee so that the insurance provider can be notified. As part of the process, the employer needs to furnish the following:
- Correct worker´s comp forms to the employee to get the claim process started
- Details concerning going back to work
Once an employer has been officially notified, the employee can begin their benefits claim. It is advised that all forms necessary should be provided to the employee within one day after the injury. As part of the claim forms packet, the employee should have one that covers the details of the injury and the circumstances surrounding it. The name of the form may be similarly known as an “Initial Report”. This form will request information regarding the following:
- Type of injury sutained
- Location of the injury
- Any injury treatment needed
- Any supplemental information
After filling out this form, it needs to be received by the insurance provider asap and in accordance with the insurer and state timeframes, they have set. Other than the forms for the claim, an employer may be required to submit additional forms to the insurance company. On top of all of that, the doctor treating the injured employee may have to submit all treatment documents to the worker´s compensation provider.
Each state may regulate how the specific process will take place and how forms will be submitted and the order in which they are submitted. Ultimately, the state has the final say in the entire process and could affect the way a worker´s comp claim is handled regardless of benefits being paid out.
Under normal circumstances, an evaluation of the claim will only take place after the necessary forms and documentation have been received by the insurance. Both employee and employer will then be notified later on if the claim for benefits will be paid or not. The timeframe for the payout of benefits will be determined by the rapidness of filing the claim, which could be more than a year. For injuries that are claimed quickly, the payout may also be quickly made, thus closing the case much quicker, too.
Keep in mind that not all worker´s compensation cases will be the same. Each of the state laws governing worker´s compensation will differ, which is why it is important to have all of the current information as soon as an injury takes place.
Conclusion
Submitting a claim for worker´s comp benefits should not feel like a chore, and it should not take a long time. When the claim is known and filed with the insurer, the benefits will be paid on a timely basis. If you see yourself in an uncomfortable situation with your employer concerning the worker´s compensation process, you should get ahold of us today. We will give you the exact information needed for your state and advise you on the options available to you.
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Posted on: Dec 15 2021
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By: admin
