Injured Worker Contact – 24 Hours Even More Critical Now
After receiving a First Report of Injury, how quickly the injured worker receives contact from the claims adjuster remains a critical element. Twenty-four business hours do not count – the deadline has to be 24 hours even if the First Report of Injury arrives on a Friday at 4 PM.
With our Risk Management claims reviews, one area of the three-point contact by claims adjusters has now become increasingly important.
The three-point contact consists of three parties: (not in any specific order)
- Injured Worker Contact
- Treating physician communications
- Employer/Insured contact
In the age of smartphones and instant information, the time when the injured employee expects contact has shortened post-pandemic.
Delaying Injured Worker Contact = $$$
Mailing a letter or sending an email may not count as Injured Worker contact. Email spam filters and the two-day minimum for a letter to arrive – if not longer – do not work nowadays.
If the injured worker first contact incurs a delay, the risk of a larger claim becomes apparent. I was unable to extract the dollar amount that delayed contact cost each employer.
Having an industrial-minded treating physician network has always been critical to claims cost. More employers now use a local treating physician network from our file reviews. The injured worker contact at the beginning of the claim shows up more often now as a contributing factor to claims cost.
Less than 15% of the claims we reviewed since the beginning of 2023 experienced a delay in getting in contact with the injured employee. However, it only takes one out-of-control claim to heavily affect an employer’s risk profile.
Usually, with a delay of three days or more, the claims progressed in this manner:
- The injured employee has sought medical treatment
- That medical treatment has now become the initial treating physician
- Interactions have occurred between the injured employee and the employer
- The injured worker has no idea what benefits are available – they have not heard from the claim adjuster on their file.
Bottom Line
I have presented and written many articles on quick initial contact. The claim is set and basically over in 48 hours. The injured worker contact needs to be a phone call, not an email or a letter/postcard.
Of course, if the employee has sought legal representation, 24-hour injured worker contact will have to go through the attorney.
As always, go with your company’s claim processing manual – always the best instructions. While you are in the manual, check out some of the other instructions on how your carrier or TPA wants their claims adjusted as they progress – such as claims diaries.
Check out the Six Keys to Workers Comp savings. The article is 17 years old, but still works today.
