North American Risk Services, Inc. Workers’ Compensation CLAIMS FILE DOCUMENTATION EXPECTATIONS ONGOING SUBSEQUENT COMMUNICATION Expectation: Update the employer every time there is a significant change in the file/status report to include the return-to-work process. Injured worker: For lost-time claims, communicate with the injured worker every 14, 30, and 45 days. • A significant change in the file • Return to work coordination • Following an appointment • Following a surgery. Send cards, flowers, etc., following a surgery. Example of communication following a surgery: A telephone call to injured worker: (123) 456-7890. Checked in to see how things were going post-surgery and reiterated benefit discussion explaining how the rate was calculated, how often benefits would be issued, and that we will continue to contact after medical appointments. Provided contact information for her to reach me should she need anything in the meantime. (INJURED WORKER) A telephone call to Barry with Green Electronics (234) 445-6789. Informed Barry that Sarah is doing well and discussed potential modified duty options for return-to-work once a release is obtained. I reminded Barry to reach out to Sarah to check in on her while off work. (EMPLOYER) Sent get well/thinking of you card to the injured worker. Text message. SECOND INJURY FUND Expectation: Document the file as noted below and as applicable. Copy and paste the template into the file and fill it in. Template Not applicable – There is no second injury fund potential for the employer, insurer, or TPA in this state. The second injury fund is available to the injured worker only, and it is the injured worker’s responsibility to pursue, if applicable. NURSE CASE MANAGEMENT Expectation: Document the file upon hiring either a telephonic or field nurse case manager to assist with medical or disability management on a file. Explain rationale. 24 25