Improve Your Workers’ Compensation Claims Handling with an Effective Incident Analysis

The term “incident” can be defined as an occurrence, condition, or situation arising in the course of work that resulted in or could have resulted in injuries, illnesses, damage to health, or fatalities. In the workplace, these incidents can be very costly if they occur, and can also be very damaging to your employees.

Workers’ compensation claims can be a tricky process, so it’s smart to examine all underlying factors in a chain of events that ends in an incident. This will help you to work through the claims process and to prevent similar incidents in the future.

Find the Cause

Those investigating should ask questions such as:

  • Was a safe work procedure used?
  • Had conditions changed to make the normal procedure unsafe?
  • Were the appropriate tools and materials available?
  • Were they used?
  • Were safety devices working properly?
  • Was lockout used when necessary?

Look at Materials

To find causes resulting from materials used, investigators might ask:

  • Was there an equipment failure?
  • What caused it to fail?
  • Was the machinery poorly designed?
  • Were hazardous products involved?
  • Were they clearly identified?
  • Was a less hazardous alternative product available?
  • Should personal protective equipment (PPE) have been used?
  • Were users of PPE properly educated and trained?

Examine the Work Environment

The physical work environment must be examined for any workers’ compensation claims. Investigators may want to know:

  • What were the weather conditions?
  • Was poor housekeeping a problem?
  • Was it too hot or too cold?
  • Was noise a problem?
  • Was there adequate light?
  • Were toxic or hazardous gases, dusts, or fumes present?

Talk to Personnel

The physical, mental, psychosocial conditions all make a difference in workers’ compensation claims. Consider these:

  • Did the worker follow the safe operating procedures?
  • Were workers experienced in the work being done?
  • Had they been adequately educated and trained?
  • Can they physically do the work?
  • What was the status of their health?
  • Were they tired?
  • Was fatigue or shiftwork an issue?
  • Were they under stress (work or personal)?
  • Was there pressure to complete tasks under a deadline, or to by-pass safety procedures?

Look to Management

Management holds the legal responsibility for the safety of the workplace. Ask questions such as:

  • Were safety rules or safe work procedures communicated to and understood by all employees?
  • Were written procedures and orientation available?
  • Were the safe work procedures being enforced?
  • Was there adequate supervision?
  • Were workers educated and trained to do the work?
  • Had hazards and risks been previously identified and assessed?
  • Had procedures been developed to eliminate the hazards or control the risks?
  • Were regular safety inspections carried out?
  • Had the condition or concern been reported beforehand?
  • Was any action taken?

Collect Physical Evidence

Physical evidence should be recorded immediately. Consider taking photographs before anything is moved and check items such as:

  • positions of injured workers
  • equipment being used
  • products being used
  • safety devices in use
  • position of controls of machinery
  • damage to equipment
  • housekeeping of area
  • weather conditions
  • lighting levels
  • noise levels
  • time of day

In some situations, witnesses may be your primary source of information if you’re unable to examine the scene immediately after the event. Witnesses should be kept apart and interviewed as soon as possible after the incident. Interviews can be at the scene to specify descriptions, or it may be preferable to be done a quiet office for fewer distractions. The decision may depend on the nature of the incident and the mental state of the witnesses.

Even if workers were not physically on the premises or present for the incident, talk to them anyway. This will help you to form a more complete picture of what was happening around the company at the time of the incident and could help you to spot any potential contradictions or discrepancies in employees’ testimonies.

About Arroyo Insurance Services

Arroyo Insurance Services was officially established in 1986, but we have roots dating back to before 1950. One of California’s leading client-oriented and independently owned agencies, we have over 140 employees with a combined experience of over 450 years, spread across 11 locations. We are committed to providing the best insurance and risk management services at the most competitive premiums, and backing it with hands-on service tailored to our customers’ needs. For more information on how we can mitigate your risks, contact us today at (877) 220-4769.