Accident Investigation for Workers’ Compensation Claims:对工伤事故调查索赔.ppt
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1、Accident Investigation,Sample Training PowerPoint,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 knowledge of the wo
2、rkers 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 employee had an injury
3、 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 employer does not inves
4、tigate, 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 24 hrs.,Investigate to Determine Greater Risk,Injury ari
5、ses 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 Investigate WC Claims?,Ne
6、eded 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 Document evidence of non-work injury Investigate
7、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? Who does the documentation go to for forwar
8、ding 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 numbers, best time to contact Provide this info
9、rmation to agency personnel to forward to WSI claims staff,Photographs,Why are photographs so important ? 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: Who is the source Was there any possible t
10、ransmission 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.,WSI Claims Staff Role,Claims staff receives information from agency Will investigate the Who, What, Where, When
11、and How questions May call with additional questions or to obtain the injured workers or witnesss statement Claims staff determines compensability,Investigations,What is an “Accident”?,Any unplanned event that results in personal injury or in property damage. Not intended Not reasonably anticipated,
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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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