Workers’ Comp Investigations – Best Practices

Uh oh.  You just found out one of your employees claims she got hurt at work.  You know you have workers’ comp coverage, but you’ve never handled a claim before.  And you’re not sure she actually got hurt at work.  What do you do?

Investigate!

  • If there was a delay in reporting the injury, review timecards and make sure the employee worked that day.
  • Talk to potential witnesses — anyone on their shift who may or may not have noticed something.
  • Obtain a statement from the employee and any witnesses.
  • Let your attorney/TPA/BWC know you want to dispute the claim.

Then, investigate some more!  If you still question the claim after your initial investigation, obtain medical evidence.  This could include the employee’s prior medical records as well as a file review or independent medical examination by a physician.

Please don’t wait!  Expensive claims can start out small.  Lumbar or knee sprains can quickly turn into a herniated disc or torn meniscus.

So, if something about a claim doesn’t seem right, talk to your attorney and investigate right away.  A thorough investigation in the beginning can save you years of headaches down the road.

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