Utilizing a Nurse Triage Program

One of the biggest factors impacting the cost of workers’ compensation claims is the time it takes for employees to receive necessary medical treatment. It’s crucial to ensure that injured workers are cared for promptly to minimize the impact of their injuries. One solution is taking advantage of nurse triage programs offered through some workers’ compensation carriers.

By using a nurse triage program, employees, employers, or both can contact a workers’ compensation nurse to assess the injured individual and determine the appropriate level of care needed. With some carriers, if an employee contacts the nurse directly, the triage nurse will document the first report of injury and immediately share the information with the relevant parties, such as the employer, and insurance company.

Providing immediate care can help eliminate or minimize employees missing work due to their injuries. Additionally, companies can benefit from receiving accurate information about the injury and reduced workers’ compensation claim costs, potentially leading to lower experience modification ratings.

What is Nurse Triage and How Can it Help You?

Nurse triage is a program that businesses use to provide a dedicated hotline for employees to call if they have a work-related injury or illness. This program is often set up by the insurance company that handles the employer’s workers’ compensation coverage. By giving employees access to a nurse, it allows for prompt and effective recommendations on treatment, as well as faster reporting of claims.

With nurse triage, employees can call the hotline at any time of day to report their injury or illness. The nurse who answers will ask a series of questions to gather all the necessary information for the workers’ compensation claim. Once the information is collected and the employee has been assessed, the nurse will determine the seriousness of the injury or illness. They will then provide the employee with advice on how to manage the injury or refer them to the appropriate level of care.

In addition to helping employees, nurse triage programs also assist with claim management. Nurses gather all the required information and, in some cases, complete the initial report of injury. Once this is done, they will notify the relevant parties, such as the employer, supervisor, physician, and insurance claims administrator, about the employee’s injury.

With nurse triage, employees can receive timely assistance and employers can ensure that claims are handled efficiently. It’s a win-win situation for everyone involved.

The Advantages of Nurse Triage for Workers’ Compensation Claims

Implementing a nurse triage program can bring numerous benefits to companies when handling workers’ compensation claims. By utilizing this program, companies can effectively reduce:

  1. Costs associated with workers’ compensation claims
  2. Time lost due to injuries or illnesses
  3. The company’s experience modification rate

Aside from benefiting companies, nurse triage programs also provide employees with valuable healthcare guidance from experienced professionals.

One significant advantage of using a nurse triage program is the potential cost savings on workers’ compensation claims. Research conducted by Hartford reveals that the earlier an employee receives treatment for a work-related injury, the lower the potential cost of the claim. For instance, reporting a workers’ compensation claim a week late could increase the cost by 10%.

Timely reporting of workplace injuries and illnesses also plays a crucial role in claim litigation. According to the National Council on Compensation Insurance (NCCI), delayed reporting significantly increases the likelihood of litigation. NCCI findings show that 22% of claims reported within 10 days are litigated, while 47% of claims reported more than 31 days after the injury occurred end up in litigation.

Providing a platform for prompt reporting and treatment of injuries not only reduces the chances of time away from work but also lowers the injury rate and associated costs. By minimizing these factors, companies can lower their experience modification rate, which reflects their workers’ compensation claim history. Maintaining a low experience modification rate results in reduced workers’ compensation insurance premiums. On the other hand, a high rate will lead to higher premium costs.

Additionally, nurse triage programs greatly benefit employees by providing them with expert health guidance. Having access to quality care and a positive experience can expedite healing and improve employee morale. Employers who prioritize their employees’ well-being foster a positive work environment and can help keep employees in good spirits during their recovery process.

Key Considerations for Implementing Nurse Triage Programs

Although nurse triage programs offer numerous benefits, it is important for employers to be aware of certain factors when implementing such programs.

Firstly, it is crucial to understand that nurse triage programs focus solely on medical matters and do not handle other aspects of the claim process. Unlike claims adjusters, program nurses do not have the same capabilities and cannot perform all the tasks typically carried out by adjusters. While medical treatment may benefit the employee, it does not guarantee faster claim closure. To achieve favorable outcomes, effective communication between the nurse and the claims adjuster is essential when utilizing a nurse triage program.

Furthermore, it should be noted that not all insurance providers utilize nurse triage programs and the worker’s compensation statutes regarding use of such programs vary by state. Some insurance companies prefer to maintain complete oversight of the claim process, and implementing a nurse triage program could potentially reduce their level of control. This could be due to the nurses’ lack of familiarity with workers’ compensation rules and regulations, leading to complications in the claims process. Therefore, it is imperative for businesses to communicate with their broker/risk advisors to ensure compatibility with a nurse triage program.

By understanding and addressing these considerations, employers can successfully leverage nurse triage programs to enhance their claims processes and ultimately improve outcomes.


When assessing a business’s needs and its workers’ compensation insurer, a nurse triage program may be beneficial. It is important to understand how the program works and what the benefits and considerations of the program would be. More than anything, it depends on what would work best for the company that would be utilizing it.

Contact us today for additional workers’ compensation guidance and resources.