what employers need to know about workers’ comp visits

July 17, 2023

According to the 2022 Workplace Injury Statistics from the U.S. Bureau of Labor Statistics (BLS)¹, almost 3 out of every 100 full-time workers were injured at work at some point over the course of the year. Jobs that require physical labor, such as health care and social assistance, retail and manufacturing led to the most injuries which ultimately has a huge impact on employers. For example, in the case of a fracture, it could lead to an average of 21 days off work or more for an employee.² Not only is this not ideal for the employee, but it can also have a great impact on the organization and productivity.

Why is Workers’ Comp Important to Employers?

The main goal of workers’ comp is to ensure that your injured workers heal while retaining a good quality of life. It may also help to reduce unnecessary ER visits and lower the cost of health care expenditures for employers. Each state has different requirements for workers’ compensation, which can be found along with contact information on the U.S. Department of Labor website.

Paying for the cost of this care is a major part of every company’s budget. According to the National Safety Council, the average cost per injured worker was $1,100, while the average cost of injuries that were serious enough to require a consultation with a medical provider was $42,000.²

If you have a company with more than 10 employees, you are required to keep a record of serious work-related injuries and illnesses (any minor injuries that only call for first aid only don’t need to be tracked). By keeping records of this information, you help OSHA to determine the safety of your workplace, understand the hazards of your industry and develop worker safety precautions that may reduce and even remove workplace hazards in the future. These records must be kept at your place of work for at least five years. Tracking and reporting of injuries is another reason to partner with MedExpress, as we handle this reporting for you and help you remain OSHA compliant.

What You Need to Know Before the Visit

First things first: the injured employee must stop work immediately. This will hopefully prevent their injury from growing worse. You may need to shift workers or call in someone to support the injured employee so that they can receive the care they need as soon as possible.

While employers or their employees are permitted to drive the injured worker to a medical facility, you may not be present for any medical treatment due to privacy issues and injured worker rights. As an employer, you are also allowed to offer transportation for follow-up appointments, as needed.

If possible, as soon as the incident occurs, the employee must contact the Human Resources (HR) department and file an incident report. This is critical so that your HR department can enact the correct protocols and notify your company’s insurance provider. Obviously, if the employee is incapacitated or in great pain, this form doesn’t need to be filed immediately, but it should be completed as soon as possible.

You may be wondering what role insurance plays during this process. Before or after the visit, a representative from the insurance company may contact the provider to get information on the extent of the illness or injury, as well as what the treatment plan will be. This information will be used to determine how much of the treatment costs that insurance will cover. They will compare this to the incident report that has been filed. Ensuring that thorough and accurate information has been captured will help aid this process. Keep in mind that while the insurance representative is legally allowed to contact providers, they are neither required nor permitted to be present during the visit.

As an employer, you should contact your insurance provider after any employee notifies your HR department of an injury. The insurance company will generate a claim number that will then be provided to the MedExpress center that your has employee visited so that we can ensure correct billing.

Documents Employees Need to Ensure a Successful Visit

When your employees visit MedExpress, they should always follow the following best practices:

• If it’s their first visit, employees should have a completed Initial Visit Authorization Form: This contains their name, basic job descriptions, applicable company contacts and who their workers’ compensation carrier is.
  After the first visit, the patient will have a chart at their MedExpress location as well as a regular provider.
• Have a filled-out authorization form: Our authorization form is used to streamline the patient check-in process. It also helps our centers to access the correct account information, so that billing and results go to the proper people.
  Employee: They should fill in their name, date of birth and the last four digits of their Social Security Number, if available.
• Employer: You should fill out your Athena account number, your company’s name and address, the scheduled date and expiration for the service we are providing, the Designated Employer Representative (DER)/company point of contact number and email, preferred communication method and the name, signature and phone number of the person who has authorized this treatment.
  To download an Authorization Form, click here.

Note: Each state has different regulations, so having thewse forms filled out before a visit will ensure a simpler and more convenient visit.

What is Included in a Workers' Comp Exam?

Prior to a workers’ comp visit to MedExpress, your HR department and employee must fill out our authorization form. When the injured employee visits MedExpress, one of our providers will conduct a comprehensive medical assessment. The provider will conduct a thorough medical assessment to assess the nature and extent of the injury. Additional testing such as X-rays or lab work may be performed, if required.

Depending on the severity of the injury, the provider will then recommend and prescribe a course of treatment that is appropriate for the injury, which may go beyond the simple rest and medication or the capabilities of the MedExpress center.

Our medical team will send patient notes, the return-to-duty Form and billing information to the insurance provider. If a referral to a specialist or further care is required, we will simplify the care process by contacting the insurance provider for approval and getting a list of in-network specialists.

Next Steps For Your Employee and You

After this initial visit, your employee may need further care or a referral to a specialist. Again, the goal of a workers’ comp visit is to ensure that they don’t just return to work, but that they come back as healthy as possible.

While unfortunate, this accident presents an opportunity to protect the rest of your employees from future incidents:

• If a slip or fall caused the injury, review the safety standards of your worksite with your employees. You may need to add some new safety protocols, such as enhanced cleaning, rails on stairs or slip-resistant material on problem areas.
• If a machine has caused this injury, it must be examined and repaired so that another employee doesn’t receive a similar injury.
• If the employee received a repetitive motion injury, such as a shoulder sprain, you may want to add rest periods to workers doing similar activities. For more information on shoulder injuries, we’ve got you covered with this article.

How Can MedExpress Help?

When you partner with MedExpress, your employees can get the right care in the right setting. We’ll focus on what’s important — getting your employees healthy and finding a return-to-work plan that considers their optimal health and safety. We’ll also help you to reduce your overall workers’ compensation costs, OSHA-recordable injuries and lost time due to injury.

Originally published April 2021. Updated July 2023. 

References:

1 Bureau of Labor Statistics. Employer-Reported Workplace Injuries and Illnesses – 2022. Last updated November 9, 2022. Accessed April 5, 2023.

2 National Library of Medicine. Length of sickness absence from work after minor fractures. Last updated January 15, 2023. Accessed April 5, 2023.

3 National Safety Council. Work Injury Costs. Last updated March 11, 2021. Accessed April 5, 2023.