Q: One of my employees told me he hurt his back while lifting a heavy box last week. He thought it would get better but it still hurts and he wants to go to the doctor. What should I do?

A: Report this incident immediately to Pinnacol Assurance or your worker’s compensation carrier! Note that you, as the employer, are responsible for reporting. At this time you must submit your policy number, name of the injured worker, the worker’s Social Security number, the worker’s occupation, and date of injury. Online reporting is fastest (www.pinnacol.com), but you may call (800) 873-7242 as well.

Inform your employee of your two designated providers (occupational medical providers who are knowledgeable about the workers’ compensation system and return to work issues), and have him or her choose and report to one of those clinics as soon as possible. Quick reporting can save up to 6 percent of the total cost of the claim, and it has been shown that the sooner the injured worker seeks medical attention, the faster that employee will get back to the workplace.

The Whens and Whys
of Workers’ Comp Claims

As a member of the Colorado Nonprofit Association’s Pinnacol Assurance Safety Group your organization is already saving 4% on your annual workers’ compensation premium. In addition to that discount, the Safety Group may earn a dividend if the Group as a whole keeps losses below a pre-determined level.

Pinnacol Assurance also tracks how quickly your organization reports claims. Statistics show that the sooner Pinnacol knows about a claim, the lower the cost for the customer. The lower cost could be the result of a lowered e-mod (“experience modification” – a measure of your claims experience) or scheduled credits from the underwriter. Lower claims costs enable the group as a whole to earn credit towards a dividend, so if even a few groups do not report their claims in a timely manner, the entire group is penalized. Your cooperation in timely reporting benefits everyone in the Safety Group.

Prompt reporting provides other benefits too. Studies have shown that claims for injured employees reported seven days from the date of injury cost 11 percent more than claims reported within 24 hours. Early reporting saves money because the claims management process begins as soon as the claim is received. Your goal is to get your employee treated and back to work as safely as possible; early reporting streamlines that process. In the event that your organization does have a claim, report that claim within 24 hours of the date of injury to Pinnacol Assurance or your workers’ compensation carrier.

Employers need to be proactive and remind workers of the importance of reporting injuries when they happen. Fear and uncertainty are the primary reasons employees delay reporting injuries, so assurance that an employee’s workers’ compensation claim will be handled in a fair and expeditious manner will alleviate their reluctance to inform their employer of an injury at work. Be sure to report the injury to Pinnacol Assurance even if you question whether the injury is truly job related.

There are several ways an employer can report a claim – phone, fax or online. The employer, not the injured worker, is required to complete the form. To see a “First Report of Injury” form logon to www.Pinnacol.com. Although you will eventually have to fill out the form completely, do not wait to report because you do not have all the answers. Your policy number, company name and address, the worker’s name and Social Security number, and the date of injury are all you need to begin the claim process. Other critical information is whether the injured worker will miss more than three scheduled days of work, and when you expect the injured worker to return to work, but again – do not wait to report until you have these answers.

On January 1, 2008 the Employee Choice of Physician law went into effect. The law requires Colorado employers to designate at least two medical providers to treat employees who are injured on the job, except for some rural areas where there are a limited number of providers. In addition, at the time of an injury, names and contact information for all the following must be provided to the injured worker in writing:

• The two designated medical providers
• The employer’s authorized representative
• The employer’s workers’ compensation carrier

A pre-composed letter (template) including this information should be kept on file for ease of compliance.

Dedication to safety and solid risk management techniques are paramount in keeping your losses to a minimum. Having a program in place that includes regular safety meetings, safety education, and management commitment to safety will keep your employees safe, and having safe employees is one of the smartest investments any nonprofit organization can make.