Navigating the Workers’ Compensation Claims Process

Workplace injuries can be stressful and overwhelming. To ensure an injured worker receives the care they need, it’s important to know the right steps to take following an injury. Whether it’s a minor injury or serious, here is your guide to navigating the workers’ compensation claims experience.

An employee is injured at work, what do I do now?

  1. Get medical treatment if necessary – If your employee’s need for treatment appears urgent, immediately get them to the nearest emergency room or call 911. For non-emergency injuries only, where there is a question if medical care is necessary or what level of care is appropriate, ICW Group offers a Nurse Triage Hotline that your employee can call to speak to a nurse specializing in workplace injuries. An injured worker can call the hotline 24/7, and English- and Spanish-speaking nurses who will start the claims process for you are available. For cases that require emergency medical care, or cases that don’t have any questions regarding the appropriate level of medical care needed, please report your claim directly to ICW Group.
  2. Report the injury – Once you are sure your injured employee is receiving the appropriate care, report the injury at Report Online on ICW Group’s website. You will also find email, FAX, and mailing instructions. Be sure to keep a link to the Claims section of our website handy so you can easily find our contact information.
  3. ICW Group will contact the injured worker – A team member from ICW Group will contact the injured worker within a few days of receiving notice of the injury or illness to obtain further information and discuss next steps, including an explanation of benefits.
  4. Understand State and Federal requirements – Your State may have specific actions to take following a workplace injury. Visit our Claims page on our website to find out. Be sure to select your State at the top of the page to your specific State’s requirements. Employers are required to notify OSHA when an employee suffers a work-related death, hospitalization, amputation, or loss of an eye. Learn more about OSHA requirements here.
  5. Are you in California? Here’s what you need to know – To avoid delays in benefits and the potential for out-of-pocket expenses, your injured employee must seek treatment from a provider in the ICW Group Medical Provider Network. Your employee can find an extensive list of preferred doctors and specialists through our directory.
  6. Are you in Texas? Injured workers can use the Texas Healthcare Network (HCN). Policyholders with injured workers in Texas can enroll in the Texas HCN to select specialized care providers with experience in treating industrial types of injuries.

Supporting your injured employee

There are many things you can do to help your injured worker through this difficult time. Your employees may be looking to you to help navigate through the claims process and their road to recovery. ICW Group has an Injured Workers Center on its website, which is specially designed for injured employees. Ease concerns by sharing this site with them. They’ll find helpful information about medical care, payments, FAQs, and more. We also have a guidebook available that you can provide your injured worker that helps them through the claims process. Both the Injured Workers Center and guidebook are available in Spanish and English.

A work injury can be a challenging experience, but knowing the steps to take can help you and your employee manage the situation effectively. If you have any questions, your ICW Group claims professionals are here to help.

ICW Group
ICW Group
ICW Group is a national, multi-line insurer with an A (Excellent) rating from A.M. Best, quoting over $3 billion annually, and the largest privately held insurance company based in California. We distinguish ourselves in the market by offering our insureds free, cost-saving services, highly proactive in-house claims handling, aggressive anti-fraud services, and industry-leading in-house risk management services designed to help insureds achieve fewer and less costly claims and lower their future premiums. For more information about ICW Group, visit www.icwgroup.com.

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