Several things need to happen quickly. You need to ensure the injured employee gets the medical attention they need, the Ohio BWC gets the reports it requires, and you contact our team at Compensation Solutions Inc, so we can help advise you on the following steps to take.
There is specific information supervisors must record immediately so that details of the incident are not lost.
Keep in mind: If it's not documented, it didn't happen!
CSI Vice President Tony Canovi says timing is critical. "Often, we don't hear from the employer. It may take a week or two before we get notified from the BWC. The main reason we ask that you contact us immediately is so that we can begin strategizing the best way to handle this claim, so it minimizes the financial impact on the company. If an incident goes a week or more without notification, we may miss a window where we could have helped you return that injured employee back to work."
Canovi reminds employers that it's the injured worker's right and responsibility to file a workers' compensation claim in Ohio. It is not the employer's responsibility. The worker must sign the form, agreeing that they want to file a workers' compensation claim. Once the claim is filed, the process begins. "CSI claims managers will call the employers and ask specific questions, so we can determine the best route to go with this claim."
What kind of information should I have ready for the CSI team?
State Fund Account Manager Andrea Watson says when an employer calls, they should have the following:
- Any incident reports on file
- Any specific accidents reported by managers
- Witness statements from any of the injured worker's friends who work around them or other employers located around them to report if there was an incident that day.
- Surveillance videos in the facility to see if they will confirm an incident occurred.
- History of the injured worker. Does that worker have a history with this employer, with any injuries previous to this one?
- How long has that employee worked with the employer?
“That helps to know the relationship and how they get along.”
CSI will also do a review of social media. Watson says, “That helps too with finding out if people have been out and about over the weekend. It happens often. So that's another review that we'll go a little bit further, and try to research that too.”
Why is time so critical in contacting CSI after an accident occurs?
"As soon as an injury occurs, you are better off filing an incident report immediately, even if the employee is not seeking medical treatment. That's the problem we see happening with a lot of clients. They don't report it, and the manager doesn't tell upper management. Internal communication issues can put a delay in the whole process."
Watson says, "{Employers} don't realize how important it is to contact us so that we can make suggestions immediately. We are their representative, and that is what we want to be.We want to be helpful, and communication is definitely necessary.."
“Red Flag” Indicators:
There are several “Red Flag” indicators Compensation Solutions Inc. considers when looking into a claim. On their own, none of these indicators would deny a claim. But CSI considers them all when determining the best approach for you to take on a claim.
The most common red flags are:
- The employee is late to report an injury to the employer.
- The accident’s date, time, and place are “unknown;” specific details of injury cannot be recalled.
- There were no witnesses to the accident. Or witness statements are inconsistent.
- The employee terminates employment just before or after the injury and never returns to work.
- The employee has a history of similar problems. Are there outside activities that could cause this type of injury, such as sports?
If you suspect fraud:
If you suspect something is wrong with a claim, you have the right to question it.
You can contact the Ohio BWC Fraud Section (at no cost to you) or speak with a private investigator (at your cost). If you believe there is evidence of fraud, you should call your account managers to discuss the situation with them.
Here's a basic step-by-step guide on what to do if there is an injury at your workplace.
WHEN AN INJURY OCCURS:
- Seek prompt medical attention for the injured employee with the preferred medical provider (as necessary).
- Contact the Compensation Solutions Inc. team at 614-799-8439, so we can advise on the following steps to take.
- Carefully investigate the circumstances surrounding the injury.
- Document all details in writing.
- Obtain witness statements if applicable.
- The injured worker should complete the First Report of Injury (FROI) form in addition to any internal incident report and sign a medical release form.
- The supervisor should document all details of the incident in writing using the
Statement of Witness to Accident and Supervisor’s Investigation Report.
- All documentation should be completed within 24 hours and sent to your CSI claims adjuster. If a claim was filed directly with the BWC by the injured employee or healthcare provider, send a copy of the claim to your CSI claims adjuster as soon as possible.