Different Approaches Construction Companies Use to Manage Workers’ Compensation Claims

A workplace injury is more than just a medical issue- it triggers a series of legal, financial, and operational steps. While workers’ compensation claims exist to support injured employees, how these claims are handled can significantly impact both the company and its workforce. In the construction industry, where physical labor and hazardous environments increase the risk of injuries, managing workers’ compensation efficiently is particularly essential. Failing to do so can lead to rising claim costs, fraud risks, and prolonged recovery times. While some companies struggle with these challenges, others take a proactive approach. They focus on streamlined processes, faster recovery, and fair treatment for their workforce. To this end, they use various strategies, including working with Medical Provider Networks (MPNs) and Third-Party Administrators (TPAs) to streamline the claims process. Having said that, below, we’ll explore the strategies construction companies use and how they impact workplace injury management. Medical Provider Networks (MPNs) for Faster and Effective Treatment Medical Provider Networks (MPNs) help injured construction employees receive proper care while controlling costs. Employers create a network of approved doctors, specialists, and medical facilities trained in occupational injuries. This ensures workers get timely and high-quality treatment. MPNs benefit both employers and employees. Businesses reduce medical costs and prevent unnecessary treatments. Injured workers provide faster care from professionals experienced in workplace injuries. A well-structured MPN speeds up recovery and helps employees return to work safely. However, MPNs require careful selection and management. Construction employers must choose reputable healthcare providers and ensure compliance with workers’ compensation regulations to prevent legal issues. A poorly managed network could lead to delays, worker dissatisfaction, and increased claim costs. Third-Party Administrators (TPAs) for Claims Management Many construction firms outsource Third-Party Administrators (TPAs) to handle workers’ compensation claims. One well-known TPA is Sedgwick, but it’s important to note that Sedgwick is not an insurance company. Instead, it manages claims on behalf of employers and insurance carriers. Sedgwick handles workers’ compensation, auto accidents, employment claims, property damage, disability insurance and more claims. Companies without in-house adjusters often rely on TPA to process claims, investigate injuries, and control costs. Since Sedgwick is hired by employers or their workers’ comp insurance carriers, some injured workers feel their claims are unfairly denied. If an employee faces challenges with Sedgwick workers comp claims, they can consult a lawyer to negotiate a workers’ compensation settlement to secure the benefits they deserve. A legal expert can review the case, gather medical evidence, and push for a fair outcome. Note: Employees should not accept a denied claim without exploring their legal options. Return-to-Work Programs to Reduce Claim Costs Construction sites rely on strong workforce participation, and extended employee absences can increase costs and slow down projects. Return-to-work (RTW) programs allow injured workers to resume their jobs sooner, even if they can’t perform full duties immediately. Employers offer modified duties based on the worker’s medical restrictions. For example, an injured warehouse worker may temporarily switch to light administrative tasks until they fully recover. A laborer recovering from a leg injury may assist in site inspections rather than active construction work. This approach keeps employees engaged and reduces lost workdays. An RTW program prevents financial strain and keeps workers engaged in their roles. For employers, it reduces workers’ compensation costs and minimizes lost productivity. A well-structured RTW program requires clear policies, cooperation with medical providers, and employer support to be successful. Employee Training and Safety Programs to Prevent Injuries Preventing workplace injuries is undoubtedly the best way to reduce compensation claims. Construction companies provide safety training to educate workers on job-site hazards and injury prevention techniques. Common safety measures include: •  Fall protection training for workers at heights. •  Proper lifting techniques to prevent back injuries. •  Protective gear requirements to reduce exposure to hazards. Another effective strategy is encouraging employees to report hazards. Workers who speak up about potential dangers help businesses address issues before injuries happen. This prevents injury, saves money, reduces claims, and creates a healthier work environment. A strong safety culture benefits everyone involved. Surveillance and Investigations to Prevent Fraudulent Claims Last but not least, workers’ compensation fraud is a serious issue, and some employees exaggerate injuries or collect benefits while working another job. Construction companies use surveillance and investigations to prevent fraudulent claims. One standard method is hiring private investigators. If an employee claims a severe back injury but is later seen lifting heavy objects at the gym, the employer has evidence of fraud. Social media monitoring is also useful. Workers posting vacation pictures while on disability raise red flags. Additionally, companies work with medical professionals to verify injuries. Independent medical exams (IMEs) help confirm whether an injury is as severe as claimed. If fraud is suspected, employers take legal action to stop false claims. Nevertheless, employers should focus on legitimate concerns rather than assume every worker is dishonest. To Sum It All Up Managing workers' compensation claims in the construction industry requires a strategic approach. Construction companies use MPNs, TPAs, RTW programs, safety training, and fraud prevention to control costs while ensuring injured workers receive proper care. However, employees must also understand their rights. If workers face delayed or denied claims, they should consult a workers’ compensation attorney to secure fair benefits and medical support.