Documentation of each accident is another important activity. It is not only necessary for complying with the law but also helps prevent similar accidents from occurring in the future.
The Texas Workers’ Compensation Act requires employers to file a first report of injury when an on-the-job injury occurs. These reports must be filed within specified time periods so it is important that documentation of an accident be both accurate and timely.
An employer, however, should not stop with what is required by law. By undertaking a subsequent investigation, you can determine the causes of an accident and what steps you must take to prevent similar accidents in the future. The investigation should begin as soon as an accident has occurred. Witnesses’ memories fade with time, and causes of an accident such as wet floors can disappear. All of the information obtained in an investigation should be committed to paper. Photographs can also be useful in documenting and investigating accidents.
Once the cause of an accident is identified, the appropriate corrective measures should be taken. This will help to keep the same accident from occurring again. In addition, all accident reports should be reviewed on a periodic basis. A review will help you to determine whether you have a particular safety problem, whether the corrective measures you have taken are adequate, and what additional measures may be necessary.
The remainder of this chapter contains information on reporting accidents and how to conduct your own investigation. It also includes forms which can be used in the documentation process.
Employer’s Guide for Handling Workers’ Compensation Clainms
Employers must keep a record of all injuries. They must also make a report to the Texas Workers Compensation Commission (on Form TWCC-1) for each death, each occupational disease reported by an employee, and each injury that results in more than one day’s absence from work for the injured employee. Records about deaths or injuries must be kept for five years from the last day of the year in which the injury occurred or the period of time required by Occupational Safety and Health Administration regulations, whichever is greater. Temporary income and supplemental benefits run for a maximum of 401 weeks, more than seven years.
All accident records must be open to inspection by the TWCC on at least five working days notice to the employer. There is an administrative penalty of up to $500 for not maintaining the records or not making them available.
A record must include:
- The name, address, date of birth, sex, wage, length of service, social security number, and occupation of the employee
- The reported cause and nature of the injury, the part of the body affected, and a description of any equipment involved
- The date, time, and location where the injury occurred
- The name of the employee’s immediate supervisor
- The names of any witnesses if known
- The name and address of the treating health care provider, if known
- Any voluntary benefits paid by the employer under Article 8308-4.06 of the Texas Workers’ Compensation Act.
The report is filed with:
- The TWCC
- The insurance carrier
- The employee at the employee’s mailing address
The report must be filed within eight days after receipt of notice of an occupational disease, or the employee’s first day of absence from work due to injury or death. The report is considered “filed” when it has been personally delivered or postmarked.
If the report is not received by TWCC or the insurance carrier, the employer has the burden of proving that the report was filed within the required time frame. Any report mailed should, therefore, be mailed certified mail, return receipt requested.
Forms required by the TWCC are available from the TWCC. Phone orders are not accepted, but a listing of all forms available can be obtained from Texas Workers’ Compensation Commission, 4000 South IH-35, Austin TX 78704-7491.
The following guidelines should be included in an employer’s checklist for reducing workers’ compensation losses:
- Experience shows that accidents can be reduced by adequate safety programs and more interest placed on such programs by management should provide more effective results.
- Report all injuries and/or occupational disease conditions immediately to your insurance representative. Such reportings should include alleged or possible claim situations, whether confirmed or otherwise. Immediate telephone reports to your insurance representative are important on claims involving: severe injuries; fatalities; any type of injury associated with an employer’s railroad operations; fraud; or allegations indicating possible misrepresentation.
- Investigate all accidents carefully to determine causes. For example: was the accident caused by another entity or company or third party. Pay particular attention to adequate documentation for reporting purposes. Don’t rely on your memory.
- An important factor in the control of cost in a claim is the employer-employee relationship. Assignment of an employer management representative to each injured worker’s claim for the purpose of “caring” will not only possibly reduce costs in that claim but also generally improve the employer’s image with his employees. Such a “care” person would demonstrate interest in the injured worker by: making certain adequate first aid or emergency treatment is administered; visitations in the home or hospital; clarification of questions involving workers’ compensation benefits; and reflecting the employer’s concern for an employee who had been injured on the job.
- Pre-employment physicals and the Identification Questionnaire are recommended to aid in placement of the employee on the right job.
- Designate one qualified person within your company to handle all of your workers’ compensation claims.
- Build and maintain a close working relationship with your insurance representative.
- Statutory protection of injured workers prohibits discharge or discrimination because the employee has in good faith filed a claim, hired a lawyer, or instituted proceedings under the Texas Workers’ Compensation Act. Termination of an injured worker for any reason can be costly to an employer or any claim pending at the time of termination. Notice to and full communication with your insurance representative prior to such termination is important.
- When possible, a representative of the employer should attend prehearing conferences at the TWCC.
- A few employees may take advantage of the system by exaggerating the extent of injury to enhance financial gain. Persistent investigation to develop facts necessary to discontinue benefits is required. When an accident results in injury to an employee, the key for controlling workers’ compensation losses is communicating with your insurance representative.