Workers’ Comp & First Aid

by Yvonne Obregon

Your place of business is more than just a place where services are provided in exchange for money. It’s a place where individuals work, friendships are made and people learn to rely upon each other. How you handle an employee’s workplace injury makes a difference to your employees and your business.

From state to state, workers’ compensation insurance requirements vary for employers.  Frequently viewed by many who work with it on a daily basis as complicated and cumbersome, knowing what insurance requirements your state has set is vital to protecting your business.

For the past few years, worker’s compensation “first aid” claims have been a hot topic of discussion amongst state insurance regulators, insurance providers, medical professionals, and employers. The countless interpretations of “first aid” claims along with the inconsistencies in reporting requirements have created a considerable amount of uncertainty and confusion amid many employers today.

 

 

What defines a First Aid Claim?

OSHA defines first aid in the same manner as many other governing agencies, “any one-time treatment and any follow up visit for the purpose of observation of minor scratches, cuts, burns, splinters, or other minor industrial injury, which do not ordinarily require medical care”. This one-time treatment, and follow up visit for the purpose of observation, is considered first aid even though provided by a physician or registered professional personnel. OSHA does expand on the definition to include use of temporary immobilization devices while transporting an accident victim, drilling of fingernail or toenail to relieve pressure, or draining fluid from a blister, using finger guards, and drinking fluids for relief of heat stress.

While the First Aid definition may vary at times, this definition has been widely accepted by most states and insurance providers throughout the United States.

Who determines a claim to be First Aid?

It is not up to an employer or an insurance provider to determine a workplace injury as first aid. It is only the authority of the treating physician to determine the treatment fits the parameters of “first aid”. The law requires all physicians who treat an injured employee to complete and file a Doctor’s First Report of Injury (DFR) for every work related illness or injury, even first aid cases. First Aid Only is to be indicated on the DFR.

If the treating physician first deems a workplace injury or illness as first aid, then the injury becomes a medical claim, the doctor must notify the employer in case a claim needs to be established with the employer’s WC carrier.

For those extremely minor injuries of scrapes, bumps and bruises that don’t require anything more than a band aid, sterile wash, or simple awareness, it is common practice and falls under reasonable and acceptable guidelines for the employee and employer to come to a mutual understanding that no physician is necessary and the injury or illness is considered first aid by both parties.

Is a First Aid Claim “Reportable”?

Who are you reporting to? There are OSHA reports, insurance carrier reports and your company internal reports.

For OSHA, a first aid claim is not an OSHA reportable work-related injury or illness and should not be recorded on the OSHA 300 log and summary.

For carriers, employers are encouraged to report all employee injuries, including first aid, to their insurance carrier.

Depending on the state, some employers are required to report all workplace injuries and illness, including first aid claims, to the insurance carrier. Since workers’ compensation laws vary state-to-state, some carrying heavy penalties and fines with them, be sure to check with your state insurance board or local insurance carrier for state specific requirements.

For your company reports, since a first aid injury or illness can develop into a reportable claim, employers are encouraged to obtain a comprehensive accident report from the employee. It is also recommended the employee be given a copy of form DWC1 in order to satisfy the employer’s responsibility.

Keeping a separate organized file of all first aid claims is a notable practice and endorsed by insurance professionals.

 

 

 

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