Who to Communicate With During a Workers’ Compensation Claim

Simply put, communicating with all relevant parties involved in workers’ compensation claims (e.g., 员工, 监事, medical providers and claims adjusters) not only provides a better experience for 员工, but it also helps employers reduce costs associated with claims. 其他好处包括, opening lines of communication to the different parties associated with claims can help employers:

• 关闭不再需要打开的声明
• Understand the required care that ill or injured 员工 need
• 让员工早日重返工作岗位
• 减少诉讼的机会

雇主可以使用本指南来教育自己，了解如何与涉及工人赔偿索赔的各方进行适当的沟通，从而使他们受益, 以及更好地支持他们的员工.

员工

Employers should communicate with 员工 from the first day the 员工 start working. 通过培养开放的沟通, 雇主可以建立信任和舒适的基础, giving 员工 the sense that they can come to their employer for any issue.

Employers should discuss the workers’ compensation claim process right away when 员工 become ill or injured. This way, 员工 will understand what is expected of them and their employer throughout the claim. 员工 should be trained on how to report occupational illnesses and injuries at the time of hire.

Open communication can also help prevent 员工 from reaggravating their illnesses or injuries. 雇主应该和员工讨论一下，当他们回到工作岗位时，他们将被分配到新的工作任务，以确保这些任务不会对他们的疾病造成任何刺激. This communication will help 员工 feel as though their employer genuinely cares for them and their health.

对于雇主来说，让他们的雇员知道他们在进行工人赔偿程序时会得到什么类型的福利是很重要的. 帮助员工了解他们的期望可以减少他们的焦虑，并在索赔过程中培养更好的关系.

雇主应该培训员工如何报告疾病或受伤，并概述在工人索赔过程中会发生什么. 员工应该明白，在他们的疾病治疗过程中，他们和雇主之间将继续保持沟通.

If an employer provides this information up front when 员工 are hired, 他们可以与员工建立有益的关系, as 员工 will know what to expect and see that their employer is following through.

除了报告疾病和受伤, 员工应该意识到，在治疗过程中，甚至在他们痊愈后的一段时间内，都会有后续的谈话.

这种做法可以帮助雇主确定员工处于康复过程的哪个阶段，以及他们是否可以更快地重返工作岗位. 跟进员工也可以防止他们因为生病而不能上班而感到孤立. 在让员工重返工作岗位和降低总体索赔成本方面，经常与员工联系可以带来巨大的好处.

那些觉得自己被雇主关心的员工往往对员工的赔偿要求不那么紧张，在治疗过程中态度也会更好. 这可以, 反过来, facilitate a quicker return to work and lead to fewer instances of 员工 filing lawsuits.

监事

监事 play an important role in workers’ compensation claims, 因为他们通常是管理层和员工之间的联络点，尤其是在员工从职业病和工伤中康复的时候, 以及在他们重返工作岗位之后. 另外, 主管可以确保员工遵守正确的医疗限制，并帮助确定在这些限制范围内员工可以完成哪些工作任务.

雇主如果不把他们的主管纳入员工补偿计划，就会错失宝贵的机会. 例如, 主管可以通过促进工作场所安全计划来帮助防止员工生病或受伤以及随后的工人赔偿要求. By communicating with 员工 daily and providing feedback on how job tasks can be safely completed, 监事 can limit the risk of illnesses and injuries occurring—thereby reducing workers’ compensation claims.

整体, 让主管参与工人索赔的沟通过程可以帮助进一步支持生病或受伤的员工, as well as offer a cost-effective way to minimize claims and related costs.

医疗服务提供者

Whenever possible, employers should be in contact with ill or injured 员工’ medical providers. Preferably, this communication should occur prior to the start of 员工’ treatment. 当涉及到生病或受伤员工的治疗参数时，医疗提供者和雇主应该达成一致. Employers cannot dictate what treatment is provided to 员工, but they can ask the medical provider to consider more conservative treatment methods over more expensive ones.

与医疗服务提供者沟通也使雇主有机会讨论他们在重返工作机会方面有哪些选择. 通过审查雇主提供的重返工作岗位服务, 医疗服务提供者可以更好地了解生病或受伤员工的典型工作任务，并确定员工应该有哪些限制. When medical providers do not understand job tasks or the nature of employers’ operations, they may just take 员工 off of work completely until they are fully healed. This practice is costly and can actually extend the healing time for 员工. 话虽如此, it is both in 员工’ and employers’ best interest to get 员工 back to work quickly. 雇主与医疗机构沟通的另一个好处是，这样做可以帮助防止医疗机构欺诈. 与医疗服务提供者建立关系的雇主将对其雇员接受的治疗质量更有信心. 这可以降低相关成本, 因为雇主会对医疗服务提供者有一种信任感和透明度——让医疗服务提供者保持诚实，不太可能对治疗收费过高.

索赔调解人

雇员以外, 索赔理算员是雇主在工人索赔过程中最重要的沟通对象之一. 与理赔理算员建立牢固的伙伴关系可以帮助雇主简化理赔流程并促进最佳结果.

理赔员负责处理员工的理赔，并分析各种索赔方面，以确定保险公司应该支付多少. 与他们的理赔理算员建立关系只会帮助雇主达到处理工人赔偿索赔的目标.

具体地说, employers should share any extra knowledge they may have regarding claims, 因为这些信息可以帮助他们的调理员. In turn, employers should listen to their adjusters’ expertise. Doing so can help reduce lost time, lower medical costs and prevent fraudulent claims from occurring.

Above all, it’s beneficial for employers to help their claims adjusters with claims. 这种做法有助于建立一定程度的信任，并鼓励理赔人员听取雇主对理赔的任何想法. 与理赔人员建立关系的雇主也可以促进更快的解决方案，如果他们在特定索赔上与理赔人员意见不一致的话. Having the right claims adjuster can also help employers uphold their organizational values and missions. 这可以 prevent 员工 from becoming disgruntled during the workers’ compensation process. If employers pride themselves on great communication with their 员工, they should work with insurance carriers that have claims adjusters with the same qualities and missions. This creates a better experience for 员工, allowing them to feel heard during the claim process. It can also make the process run smoother and seem less challenging for 员工.

很明显, 与索赔理算员沟通的雇主可以帮助建立稳固的关系，并确保他们充分参与索赔过程.

前进

整体, communication goes a long way in the workers’ compensation process. There are many benefits to keeping in contact with all the parties involved in workers’ compensation claims. Such communication provides a low-stress process for 员工, reduces costs for employers and can create more efficient claim experiences as a whole. 

本报告并非详尽无遗，任何讨论或意见也不应被视为法律建议. Readers should contact legal counsel or an insurance professional for appropriate advice. ©2021 Zywave, Inc. 版权所有.