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Managing Claims Overview
Claims Coordinator Responsibilities Choosing a Medical Provider When an Injury Occurs Finding Out About an Injury Your Five-Step Response First Report Checklist What the Employee Receives Handling Medical Records Situations to Watch For Report an Injury Return to Work Fraud Lowering Your Costs |
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Situations to Watch ForLearn from others' reporting mistakes and save yourself time, money and headaches. An employee is missing workIf the injured employee is missing time from work, it is crucial to include this on the First Report and notify your SFM claims representative. While lost-time may not be immediately payable, it does trigger states' deadlines for when benefits are due to the employee. Information changesIf an employee starts missing time from work after you have sent in the First Report or you find out the employee has moved, call your claims representative immediately with the updated information. You receive a medical billYou shouldn't receive any medical bills for an injured employee. If you do, send them directly to your SFM claims representative. Don't ever pay a bill. This is an admission of liability. You question the injury's legitimacyYou may believe an injury is not work-related, or even suspect fraud. Still, by law you must report every claimed injury—even if it's questionable. Reporting an injury does not admit liability. It means an employee claimed an injury occurred at work. Use confidential comments to note your suspicions or contact your SFM claims representative. Remember that the injured employee receives a copy of the First Report. It's just a minor injuryAll injuries should be reported to SFM, even minor ones. SFM does not set aside reserves for any incidents that don’t require medical treatment or lost time from work, so the claim is opened and closed the same day and will not affect your premium. By reporting an incident, you are preserving the necessary information you will need if the injury later requires medical attention or lost time from work. Other best practices to keep in mind:
View full detail on avoiding reporting mistakes (PDF)
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