Accident Investigation for Workers’ Compensation Claims对工伤事故调查索赔.ppt
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1、Accident Investigation,Name, Job Title Phone number E-mail address,Purpose of Presentation,Overview of workers compensation accident investigation process Value of investigation following an accident (whether compensable or not) Elements of Accident Investigations,Goals & Objectives,Increase your kn
2、owledge of the workers compensation accident investigation process Identify methods of investigation Determine the causes of accidents Identify tools used in the investigation process Fine tune your accident investigation skills,Employee Must Provide “Notice”,Why: To notify the employer that the emp
3、loyee had an injury at work so that the incident can be investigated.,Employee Notice of an Accident,(Insert your agencys reporting policy and key process steps) Immediate written notice required Enables prompt investigation of facts Allows employer to provide necessary medical attention If the empl
4、oyer does not investigate, may not be able to prove the facts.,Best Practices,Injured worker should immediately notify his/her supervisor The supervisor should investigate or notify whoever is responsible for agency investigation immediately! Submit claim within 5 days,Investigate to Determine Great
5、er Risk,Injury arises from a risk not shared by the general public There is a causal connection between the injury and the employment Employee exposed to a particular danger The risk is peculiar to the employment,How Can You Help?,On-Site Investigators Role In Workers Compensation Claims,Why Investi
6、gate WC Claims?,Executive Order 52 (99) Needed to assist claims staff Determine cause Document scene Document what people said and saw Prevent future accidents,Documentation,Document information you hear Document the scene through photographs, sketches, written descriptions, video recordings Documen
7、t evidence of non-work injury Investigate facts that contradict injured workers version Investigate personnel or disciplinary problems that impact the claim situation,Documentation,Insert information here on your agencys policy Do you have internal forms? Where does the investigator get the forms? W
8、ho does the documentation go to for forwarding to the claims staff? What timeframes are in place for completing the investigation? Any timeframes for follow-up for correction of hazards?,What Else?,Gather contact information on witnesses & supervisors Obtain witness and supervisor names, phone numbe
9、rs, best time to contact Provide this information to agency personnel to forward to claims staff,Photographs,Why are photographs so important to OWC? Support facts Document scene Become the “eyes” for people not in the field May be required if litigated,Exposure to Blood or Other Body Fluid,Document
10、: Who is the source Was there any possible transmission of disease Contact with cuts, scrapes Contact with eyes, nose, mouth,Exposure to Blood or Other Body Fluid,Insert your agencys policy on how to handle exposure incidents here.,Claims Staff Role,Claims staff receives information from agency Will
11、 investigate the Who, What, Where, When and How questions May call with additional questions or to obtain the injured workers or witnesss statement Claims staff determines compensability,32.1-45.1 Code of Virginia Deemed Consent,Covers health care workers, law-enforcement officers and 1st responders
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- Accident Investigation for Workers Compensation Claims对工伤事故调查索赔 Workers Claims 工伤事故 调查 索赔
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