Navigating Workers’ Compensation Claims

As a business owner, you’re responsible for providing your employees with the coverage they need to protect themselves in the event of a work-related injury. Even with the best safety protocols in place, workplace incidents can still occur. That’s why it’s important to understand how to handle workers’ compensation claims and ensure that you’re taking care of your employees.

What Is Workers’ Compensation?

Workers’ compensation is a type of insurance that protects employees if they get injured at work or develop a work-related illness. It’s mandatory in every state, which means all businesses must carry a policy to cover their workers’ injuries and illnesses.

Workers’ compensation pays for medical bills, lost wages, and other expenses stemming from an injury or illness that occurs on the job. Your state’s workers’ compensation board runs the program, which determines the rules for filing a claim and how much you will receive as a settlement. Check with the board to see what you need to do.

While workers’ compensation provides your employees with medical and financial support, it can also protect you from expensive lawsuits. In most cases, an injured worker can’t sue you for pain and suffering if they get coverage. The one exception is if your employee can prove that someone intentionally caused the injury.

How Can You Manage Prescription Drugs?

There are several different types of prescription drug coverage for workers’ compensation. Depending on the type of coverage your business selects, you may have a set number of prescriptions available or unlimited coverage.

One way to manage prescription drug benefits for workers’ compensation is to find cost-effective drugs. First, refer to your plan’s formulary, which lists all the medications that the plan includes and their associated costs. Next, decide which drugs you would like to cover and search for less expensive alternatives.

A pharmacy benefit management company can help you manage prescription drug costs. The top PBMs are masters at controlling the drug supply chain, negotiating directly with drug manufacturers to get the lowest possible prices.

PBMs offer other services as well. They can help speed up the diagnostic process by ensuring that employees have access to appropriate testing and follow-up care. This can help employees get the right treatment as soon as possible, improving their outcomes and allowing them to return to work more quickly.

The PBM can also help with compliance by providing employees with the tools and resources they need to stay on track with treatment. This can include offering online portals to track progress, secure messaging services to connect with providers, and mobile apps to track medications and dosages.

What Are Common Mistakes When Filing a Claim?

There are a few common errors that people often make when handling a workers’ compensation claim. These errors can significantly impact the outcome of your claim and the amount of time that it takes to process.

One of the most common mistakes is failing to submit the claim in time. Each state has a statute of limitations that people must follow for a workers’ compensation claim to be valid. Failing to file the claim within the allotted time can result in your insurance company denying your claim.

Another common mistake is failing to submit proof of your employee’s injury after it happens. This can include things like medical bills, radiographs, physician notes, and other documents. If you fail to submit all necessary documentation, your insurance company may deny the claim or, at the very least, delay it.

Also, many business owners give up quickly and don’t appeal their denied claim. If you don’t take advantage of your right to appeal, your claim will be over and your employee will not get benefits, which can lead to serious problems.

Not having an attorney is another mistake you could make when dealing with workers’ compensation claims. You may not need an attorney, but if you’re struggling with navigating the workers’ compensation process on your own, it’s in your best interest to find a professional who knows how the system works. This way, you can ensure that your insurance company is handling your claim properly.

It’s not always easy to handle workers’ compensation claims. The complexities of the system can be confusing, and it can be difficult to stay organized and on top of the paperwork and deadlines. However, with the right knowledge and preparation, you can navigate the system and obtain the benefits your employees deserve.