Workers' Compensation is defined as an insurance that entitles eligible employees to receive benefits while they recuperate after a work related injury. But this simple definition does not encapsulate the significant challenges for employers and HR departments to effectively manage workers' compensation claims.
HR departments often struggle with managing the Workers' compensation process, especially when using manual processes and paper tracking. With just one claim, there are many steps required from determining eligibility, through the process to comply, manage, document, track the claim to the end. This complex process can be error prone and mistakes or omissions leave an organization open to risk.
What is a typical Workers’ Compensation claim process?
Workers' Compensation claims are just that, claims. Just like any other insurance the claim, it is a request for benefits that kicks off a review process to determine eligibility and the benefits that can be received based on the qualifying event.
However administering Workers' Compensation claims have several steps. The requirements also vary from state to state. So workplace injuries kick off several different processes and those processes can be different for different employees and/or locations. But each needs to be tracked and documented to keep compliant and to manage company absenteeism.
Administering claims is a process-heavy, leave of absence case, which must be managed closely with a goal of getting the employee back to work ASAP. There are three areas the HR professional must manage
- Manage the claim - Investigations, filing claim, status, reporting
- Manage the employee - physical limitations, doctors appointments, accommodations, light duty work, extensions to leave and return to work status.
- Manage dates, doctors notes and other documentation - extensions, return to work dates, permanent disabilities and employment separation as a result of the leave
The employee returning to work is the goal; no one should get lost while on leave.
How do Modern HCM solutions streamline compliance?
Once a Workers’ Compensation claim is determined to be eligible, HCM solutions allow HR departments to track and complete every step of the process. The claims-specific data, related to the injury, can be tracked on the employee's profile including the injury/illness and investigation.
Claim management workflows can be built for different state requirements. This streamlines the process so forms and dates aren’t missed. All information for contacts, physicians, claims examiner, Medical Records Officers, financial information, disability rating, etc are managed all in one place. Instant access to view and track all elements of the workers’ compensation in a snap shot saves time, reduces human error, keeps you organized for quick audits.
What else can OnePoint Do?
Additionally, the HCM is your guide to closely managing the Workers’ Compensation leave. Eligibility for leave, entitlements under those leaves, and time previously taken, are calculated within the system rules. This ensures employees are paid correctly for their PTO by company rules for PTO and timesheet completion, if applicable. Utilizing seamless data transfer it is easier to track forms, documentation, and get the required signatures completed quickly and electronically. This level of case management streamlines processes to avoid the layered law landmines.
Interested in Workers’ Compensation Strategies?
Watch “Demystifying Workers’ Compensation” On Demand.