After reporting an injury
After your employee’s immediate medical needs are taken care of, follow these four steps:
Investigate the incident.
Try to figure out the cause so you can prevent similar injuries in the future. It helps to talk with witnesses and take a look at the scene of the accident. It can also be helpful to take photos and save any equipment involved.
Stay in contact with the injured employee.
Injured workers often feel isolated and worry they’ll lose their job. Ease their fears by letting them know you care about their wellbeing and look forward to their return to work.
Point them to the injured workers section of our website where they can find resources and answers to common questions.
Injured workers often feel isolated and worry they’ll lose their job.
Arrange for return-to-work.
As soon as a doctor clears the employee to return to work, find a way to bring them back, even if they can’t yet return to their pre-injury job due to medical restrictions. Options include finding a temporary light-duty position, reducing hours or adjusting the employee’s regular job to accommodate restrictions.
Notify your claims representative right away if the employee will be off work.
This gives your claims representative time to determine whether the injury is covered by workers’ compensation, and pay wage-loss benefits before your state’s deadline.
Keeping up with claim developments
Use our CompOnline® risk management system to see claim details and track payments
Getting and handling medical data
State laws grant employers access to injured employees’ medical records to see work restrictions ordered by physicians.
Keep these rules in mind when handling confidential medical records:
- By law you can’t combine medical records with the employee’s personnel file. Keep a separate medical file.
- Never give medical information to a third party without the employee’s written consent.
The Health Insurance Portability and Accountability Act (HIPAA) generally allows employers to discuss an injured employee’s progress and medical status related to a work injury with the employee’s treating physician. Medical providers may be unclear about the HIPAA law as it applies to workers’ comp and may be reluctant to give you information. If this happens, call your claims representative at (800) 937-1181.Go to the U.S. Department of Health and Human Services page on disclosures for workers’ compensation purposes
If you suspect fraud
Fraud is rare, but sometimes employees do intentionally misrepresent the facts surrounding their work injuries.
Even if you suspect fraud, report the injury to SFM right away just as you would with any other work injury, and let your claims representative know your concerns or email us.
SFM’s Special Investigations Unit and in-house attorneys are prepared to investigate, evaluate and pursue fraudulent claims.