{"id":5097,"date":"2016-04-04T10:47:54","date_gmt":"2016-04-04T15:47:54","guid":{"rendered":"https:\/\/content.findlaw-admin.com\/ability-law\/smallbusiness\/liability-and-insurance\/handling-a-claim-employer-and-employee-responsibilities.html"},"modified":"2024-05-23T02:21:10","modified_gmt":"2024-05-23T07:21:10","slug":"handling-a-claim-employer-and-employee-responsibilities","status":"publish","type":"page","link":"https:\/\/www.findlaw.com\/smallbusiness\/liability-and-insurance\/handling-a-claim-employer-and-employee-responsibilities.html","title":{"rendered":"Handling a Claim: Employer and Employee Responsibilities"},"content":{"rendered":"\n
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Handling a Claim: Employer and Employee Responsibilities<\/h1>\n
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\n By FindLaw Staff<\/a> | Legally reviewed by Aviana Cooper, Esq.<\/a>\n | Last updated\n
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The last updated date refers to the last time this article was reviewed by FindLaw or one of our contributing authors<\/a>. We make every effort to keep our articles updated. For information regarding a specific legal issue affecting you, please contact an attorney in your area<\/a>.<\/em><\/p>\n\n <\/div>\n <\/details>\n<\/section>\n

Accidents happen. There are procedures to follow when an employee is injured<\/a> at work. Business owners and employees have responsibilities they must fulfill for things to proceed. Although the specifics of the laws will vary from state to state, there are some general duties that apply nationwide. Below is a discussion of employer and employee responsibilities in <\/span>workers’ compensation claims<\/a>.<\/span>
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Employer Responsibilities<\/h2>\r\n

Every state except Texas requires employers to carry workers’ compensation insurance. Small business insurance policies are available for small companies. Businesses with even one employee must have some type of workers’ compensation<\/a>.<\/p>\r\n

As an employer, you are responsible for avoiding workplace injuries by providing your employees with a safe place to work<\/a>. After an employee injury, you must complete a First Report of Injury<\/a> and forward it to your workers’ compensation carrier.<\/p>\r\n

You are responsible for ensuring you do not violate any laws or rights of the injured employee. If an injured employee needs medical attention for a serious injury, allow them to see the company doctor or leave work to see their own doctor.<\/p>\r\n

Cooperate With Your Insurance Carrier<\/h3>\r\n

You are responsible for cooperating with your workers’ compensation carrier<\/a>, claims adjusters, and attorneys in investigating the matter. These parties will likely need your documentation of the injured employee’s payroll history. They may request a copy of the injured employee’s personnel file<\/a>. They may ask to speak to the injured employee’s supervisor or co-workers to confirm the injured worker’s story. Provide them with timely assistance. It will help to be familiar with your insurance policy.<\/p>\r\n

When an attorney for the employee contacts you, inform your workers’ compensation carrier or their attorney. Do not provide documents to anyone else. Let your carrier and attorney take care of those requests, if appropriate. Treat this like any other business insurance claim, and let your legal team handle it.<\/p>\r\n

Employee’s Return to Work<\/h3>\r\n

You are responsible for welcoming an injured employee back into the workplace<\/a> once they can return to work. You may not penalize or terminate an employee because they have filed a workers’ compensation insurance claim. If you do, you may face serious civil or criminal charges.<\/p>\r\n

Workers’ Compensation Board<\/h3>\r\n

You are responsible for assisting your state workers’ compensation board in curbing fraud<\/a>. Most people know an employee can commit fraud by lying about an injury or exaggerating symptoms. However, employers can also commit workers’ compensation fraud. For example, you cannot limit your First Reports of Injury in the hope that keeping your claims history down will reduce premiums. It will not take long for your injured employees to determine why they are not getting their benefits.<\/p>\r\n

Employee Responsibilities<\/h2>\r\n

Employees have a duty to act responsibly while at work. Worker’s compensation benefits<\/a> will not apply in all situations. Some types of claims are specifically excluded from workers’ comp. Covered injuries and illnesses include:<\/p>\r\n