Claims Process

24/7 Nurse Care Line

An injured employee needs to advise their supervisor immediately after an injury. As soon as the injury is reported, the injured worker and their supervisor should call the 24/7 nurse triage line. If the supervisor is not available, the injured worker should call alone. Of course, if it is an emergency, call 911. Explain the injury to the nurse and the nurse will provide triage recommendation ranging from self-care to a clinic referral. The injured worker will receive the nurse's phone number and can call the nurse line back anytime they have concerns or questions.

Minnesota Comp Advisor partners with Alaris to connect employees to a nurse triage line, available 24/7 at no cost to the employer or injured employee. Learn more about the 24/7 Nurse Care Line.

Reporting/First Report Online (FROL)/OSHA 300

Reporting your workplace injuries through First Report Online (FROL) or through your insurance carrier's online filing system is a vital way to help you manage your employee injuries. Reporting on time, thoroughly and accurately, can ensure your claim is processed in a timely manner, and save on the overall cost of claims. Failure to meet reporting requirements can cost you in penalties, delays in return to work, increase medical costs, and increase the likelihood of lost time (indemnity). Plus, the longer and employee sits at home, the more likely they are to contact a lawyer. According to the National Council on Compensation Insurance (NCCI), delays in reporting work-related injuries can cause costs to increase up to 51%.

First Report Online makes filing a claim faster and easier. The online system provides specific fields for each area of detail that is needed -- the more specific detail you can provide, the easier the claims process, and the better the results. The system will automatically:

  • Auto fill all physician and clinic location details on the FROI
  • Auto fill carrier and company department information on the FROI
  • Allow you to run trend reports
  • Save you time
  • Send the First Report of Injury to:
    • Carrier
    • Minnesota Comp Advisor
    • Company Management
  • Calculate lost time
  • Generate all OSHA reports including:
    • OSHA 300
    • OSHA Summary

For best results, have your organizations' claims coordinator, or HR manager complete FROL reporting. Employees may provide inaccurate information because they don't understand what's being asked, or they may alter details about what happened or how much they're being paid.

Med Clinics and Positive Outcomes

One of the biggest challenges faced by key players in the work comp system is when the injured employee does not see the right health care provider. The doctor gives needless time off for a minor injury and this practice negatively affects both the employee and employer. The employee is set down a path to "disability syndrome" where they come to expect time off every time they are injured, regardless of the severity. The American Medical Association (AMA) estimates that 7 out of every 10 days given off in connection with a work comp injury are medically unnecessary. The AMA continues with clinical information on how bad it is to sit home instead of healing at work. When meeting with a new employer, we often see small lost time claims on their experience mod. Lost time claims do not receive the 70% discount when the mod is calculated and thus the claim could cost the employer 3 times what the carrier paid to begin with!

In advance of claims, a med clinic relationship with the proper doctors needs to be established. Occupational providers are preferred, but training can be provided to family and ER doctors so that they understand what is at stake for both the employee and employer. Injured employees are then given direction on which facility to see. It is up to the employee to choose, however 93% of all injuries are first time work comp injuries and in our experience, most appreciate having a good referral up front.

Drug Testing

Employees who test positive for drugs after sustaining a work-related injury may be denied workers compensation in the State of Minnesota, but first, employers must have a solid drug testing policy and systems in place to help ensure the safety of their employees, and keep workers compensation claims costs down.

Return to Work

An effective Return to Work (RTW) program is a critical element of a cost containment policy designed to eliminate wasteful spending and reduce the cost of workers compensation insurance. In this context, it is a concept dedicated to helping injured workers get back to work, by providing them with temporary, modified jobs that take into consideration physical restrictions, skills, interests, and capabilities. It is also part of disability management.

As the employee's health and strength improve, job tasks are gradually increased until the employee is back to work and functioning at full capacity.

Facts About Return to Work and Injured Workers

  • 60% of workers who are away from the job longer than 14 days are already in financial trouble.
  • A patient's emotional distress usually increases as days away from work increase, and so does the resulting number of surgical procedures. This is greatly reduced when a worker enters a productive role-including modified duty.
  • 80-90% of workers injured on the job would rather be working than recovering at home.
  • A recent study by the California Workers Compensation Institute shows that the chances of litigation are reduced by 50% if the employer contacts the injured worker within one week after the injury occurs and positively reinforces the worker's self-image and value to the company.
  • Returning an injured worker to the work place reduces associated recovery costs including medical expense, rehab expense, therapy, and surgical expense. Often the percentage of permanent impairment is significantly reduced.
  • Typically, the claimant will contact an attorney 2 weeks after injury.
  • 80% of all litigated claims result in higher settlements.
  • Workers who retain an attorney see an average of 5.2 doctors. Those who do not retain an attorney are treated by an average of 2.0.
  • Early return to work programs have proven effective in reducing attorney involvement, quicker recovery, and reduced related costs while providing an excellent employee benefit.

The Goals of Return to Work

  • Accelerate the employee's return to work by addressing the physical, emotional, attitudinal, and environmental factors which otherwise hinder the return to work process.
  • Facilitate temporary or permanent job reassignment of job restructuring.
  • Identify alternative employment consisting of modified duties.
  • Reduce the number of cases entering the workers compensation litigation system.
  • Decrease the number of lost work days.
  • Increase employee morale and motivation to return to and remain at work.
  • Assist in compliance with the American with Disabilities Act.

How the Employer Benefits

  • Reduce workers compensation insurance costs.
  • Promote good will and enhance corporate image.
  • Allow active participation of management in the employee's recovery.
  • Reduce costs of temporary or replacement workers.
  • Reduce potential for litigation.
  • Maintain an experienced work force.
  • Minimize productivity slow down.
  • Improve employee/management relations.
  • Promote employee morale/security.
  • Improve work ethic.
  • Decrease opportunities for repeaters and malingerers.
  • Decrease potential of re-injury.
  • Tie workers, supervision, and management together.

How the Employee Benefits

  • Provides sense of security and stability.
  • Reinforce management commitment to employee welfare.
  • Reinforce a positive self-image to injured worker.
  • Provide positive reinforcement to injured worker to recover quickly.
  • Discourage the "disability syndrome" thought process.
  • Encourage normal working relationships with other employees.
  • Reinforce the "going to work daily" habit.
  • Allow injured worker to directly contribute to profitability of employer.