Drift report

When an employer client reports a lost-time injury, confirm the Employer's First Report of Injury (DWC Form-001) has been filed with us as carrier representative. Our standard requires the employer's report within 15 days of the employee's first missed day beyond the date of injury. Log the report date in the claim system and follow up on late filings.

Upon receipt of written notice of injury, the adjuster must either initiate benefit payments or issue a written notice of refusal with stated grounds to the Division and the employee within 30 days of the notice. Document the action taken and the mailing date in the activity log.

The carrier's right to contest compensability lapses if not exercised on or before the 90th day after written notice of injury, except on newly discovered evidence that could not reasonably have been obtained earlier. Calendar the contest deadline at intake and escalate at day 45 if the investigation is incomplete.

No income benefits are payable for the first week of disability under any circumstances. Begin income benefit payments with the second week of disability and continue on the weekly schedule. Waiting-week amounts are never paid retroactively.

Process complete medical bills promptly. Final action — payment, reduction, denial, or audit determination — must be taken within 60 days of receipt of a complete bill. Bills pended for audit must carry a documented audit plan and follow the audit timeline.

When the employee reaches maximum medical improvement with a certified impairment rating, begin impairment income benefits the following day at 70% of the average weekly wage. Pay two weeks of IIBs for each percentage point of the impairment rating, then close the income benefit line.

Diary every TIBs claim for duration review. Temporary income benefits may continue until the employee reaches maximum medical improvement, up to a maximum of 156 weeks measured from the eighth day of disability, whichever comes first.

Employer clients are instructed to submit their first report of injury together with the first weekly payroll transmission following the injury — in practice within two weeks of the first lost day — so wage data and the injury report arrive as one package.

Employees are required to report a work injury to their employer within 45 days of occurrence. Where first notice to the employer falls outside that window and no statutory exception applies, prepare the notice defense workup for supervisor review before any dispute filing.

Initiate benefits or file the notice of refusal within 15 days of written notice of injury as required. Where the investigation is incomplete, adjusters may request an internal extension of up to 30 days from notice before the pay-or-dispute action is taken, documented in the claim notes.