Reporting a workers’ compensation claim is a critical first step in effective injury management. Whether the situation involves an incident-only report, a medical-only claim, or a lost-time injury, timely reporting allows the claims process to begin immediately.
Filing a claim does not automatically mean it will be accepted as compensable or that benefits will be paid. It simply ensures the claim can be reviewed, investigated, and addressed appropriately. Prompt reporting protects both the employee and the employer.
Record-Only Claims
Incident-only or record-only claims document what occurred, even when no medical treatment is sought at the time.
This documentation:
- Preserves details that may otherwise be forgotten
- Allows faster action if treatment is later sought
- Supports timely vendor referrals or defense coordination if needed
- Helps avoid potential penalties for delayed reporting
For TBG’s record-only claim process, these claims are closed without contact and generally are not included in MOD calculations. However, having the claim in the system ensures you are prepared if circumstances change.
Medical-Only Claims
Medical-only claims are assigned immediately. Our team contacts the Member and known medical providers to coordinate care and billing.
Early reporting allows:
- Clear communication with all parties
- Timely updates on treatment and workability
- Proper billing direction to avoid delays
- Acknowledgement letters to both the injured worker and the Member
This proactive approach reduces confusion and supports a smoother recovery process.
Lost-Time Claims
Lost-time claims require immediate reporting. Timing is critical.
Prompt assignment allows for:
- Timely investigation and compensability review
- Coordination with medical and rehabilitation providers
- Required state reporting
- Payment or denial decisions within the 14-day statutory timeframe
Meeting these deadlines helps avoid penalties and reduces uncertainty for the injured worker.
We Are Here to Help
When in doubt, report the claim.
If you have questions about filing procedures or claim classification, contact the TBG Claims Services team. Early communication and partnership are key to protecting your employees and managing costs effectively.
