The following checklist is for employers and supervisors and outlines how they should document any kind of work-related injuries or illnesses for workers’ compensation purposes. It’s crucial that these steps be taken as soon as possible in the event of any kind of medical emergency or serious injuries.
Provide the employee with a Workers’ Compensation Information and Privacy Statement form and have them review and sign it.
Provide the employee with an Employee Statement regarding injury/illness/incident form and have them fill out the statement as soon as they can, no later than 24 hours.
Complete Incident/Injury/Illness Data Form with the employee and then submit the form to a Workers’ Compensation Coordinator no later than 24 hours.
Complete the Agency Claims Investigation form and submit it to a Workers’ Compensation Coordinator no later than 24 hours.
Provide the employee with a Workers’ Compensation Employee Information Packet and review the documents to ensure the employee clearly understands the process.
Provide the employee with a temporary CorVel RX First Fill pharmacy card that they can take to their first doctor appointment.
Inform the employee about a CorVel network clinic.
Inform a Workers’ Comp Coordinator if the employee is seeking medical attention or is expected to miss work because of the work-related injury or illness.
Contact CorVel’s 24-hour Nurseline if the employee is treated in the ER, is staying overnight at a hospital or requires immediate surgery.
Document all witness statements and contact information, particularly names and numbers.
Secure and isolate any faulty equipment that contributed to the employee’s injury.
Get a Report of Work Ability copy from the employee if they did seek medical attention for the injury.
Other Actions To Take Until The Employee Has Fully Recovered And Is Working:
Get a Report of Work Ability form from the employee for each appointment, and forward this to a Workers’ Comp Coordinator.
Notify a Workers’ Comp Coordinator if the employee does not initially seek medical attention, but does so later on.
Provide employee with ongoing assignments within the restrictions of each Report of Work Ability.
Review timesheets to ensure an accurate indication of the lost time due to the work-related injury or illness.
Contact An Experienced St. Paul Workers’ Compensation Attorney
We have offices in St. Paul and White Bear Lake and serve clients all throughout Minnesota, so if you or a loved one has been injured at work please call our injury lawyers to discuss your case. Our team can help you with any cases involving a denial of workers’ compensation benefits, as well as a potential claim against a third party. To arrange a free consultation with our trusted lawyers call 651-291-7263, or SEND US A MESSAGE online.
