What this is
What is a claim support record?
What is a claim support record?
A claim support record documents what an employer provided to support a workers compensation claim: the incident and investigation evidence handed over, whether the employer's report was submitted on time, whether the worker was helped through the process, and how the claim resolved. It is administrative rather than clinical, and it exists so the material given to the insurer or board sits in one place instead of scattered across email.
How is this different from the claim itself?
The claim is decided by the workers compensation board or insurer, based on medical evidence, the injury circumstances and the applicable legislation. The claim support record is the employer's side of the paperwork: what was submitted, when, and whether the worker was properly assisted. It does not decide anything; it evidences that the employer's obligations were met.
Who completes a claim support record?
HR, working with occupational health where clinical information is involved. Occupational health holds anything diagnostic; HR holds the administrative trail, the deadlines, the consent, and the correspondence with the insurer. The two roles are kept apart deliberately, because management does not need a diagnosis to support a claim, only a fitness outcome and a restriction list.
Scope
When is a claim support record required?
This record supports one claim through its administrative lifecycle. Using it for the clinical case behind the claim, or for the return to work plan itself, moves work that belongs to a neighbouring template into this one.
Use this template when
- A workers compensation claim has been lodged, or is about to be, and the employer's side of the paperwork needs to be tracked
- The employer's report has to be submitted to the board or insurer within a statutory deadline
- Evidence such as an incident report, investigation findings or exposure records needs to be assembled for the claim
- The claim's status changes, submitted through to a decision, dispute or appeal, and that change needs recording
- A linked record needs this one to exist: links case, worker
Do not use it for
- Occupational Health Case Record, which tracks the health case from first report through to closure, and is where the clinical narrative belongs
- Case Progress Review, which reviews how the case is progressing against its expected timeline, not what was submitted to the insurer
- Case Closure Record, which closes the health case and records the outcome and any lasting restrictions
- Stay at Work Record, which is a prevention record for keeping a worker at work on adjusted duties, not for administering a claim that has already been lodged
- Anything outside KnowHealth, which belongs in the workspace that owns that process
Compliance mapping
Which WCB requirements does this satisfy?
Workers compensation is a statutory scheme, not a management system standard, so the obligations come from provincial or state legislation and the board's own rules rather than a numbered clause set.
| Clause | Requirement | Where it lands |
|---|---|---|
| Workers compensation legislation — employer's report of injury duty | Employer must submit a report of the injury and claim circumstances, typically within a fixed number of days | Submission |
| Workers compensation legislation — timeliness of employer submission | Late employer reporting is itself a recordable failure, independent of the claim's eventual outcome | Submission |
| WCB — duty to cooperate with the claim | Employer must provide evidence reasonably requested by the board, including incident, investigation and exposure records | Evidence provided |
| Health information / privacy legislation — consent to disclosure | Medical or health surveillance information may not be disclosed to support a claim without the worker's consent | Evidence provided |
| Workers compensation legislation — return to work cooperation duty | Employer must cooperate with the insurer's return to work planning once a claim is accepted | Status |
| Workers compensation legislation — dispute and appeal rights | Worker retains a statutory right to dispute a decision, and the employer's record should reflect that process where it is invoked | Status |
What it does not cover
- Occupational Health Case Record, which tracks the health case from first report through to closure, including the clinical detail this record excludes.
- Case Closure Record, which closes the underlying case and records the outcome and any lasting restrictions.
- Modified Duty Plan, which sets out the actual temporary duties a recovering worker performs, rather than the paperwork behind the claim.
- Stay at Work Record, which prevents a claim by keeping the worker at work on adjusted duties, a different instrument from administering one already lodged.
- The claim decision itself, which is made by the board or insurer against medical and circumstantial evidence, not by this record.
Global
Claim Support Record requirements by country
Workers compensation is administered at state or provincial level almost everywhere, so the instrument and the deadline both vary by scheme even where the underlying duty, support the claim promptly and honestly, does not.
State workers compensation statutes; OSHA recordkeeping under 29 CFR 1904
No federal scheme. Each state sets its own reporting deadlines, forms and dispute process.
An employer operating across states needs deadlines and evidence requirements tracked per state, since a form or timeframe that satisfies one may not satisfy another.
Provincial Workers Compensation Board legislation
Employer's report of injury has a statutory deadline, commonly within days of becoming aware of the claim.
Late reporting is sanctionable in most provinces independent of whether the claim is accepted, so the deadline is tracked separately from the outcome.
Statutory Sick Pay and Industrial Injuries Disablement Benefit framework
No equivalent WCB structure. Support runs through statutory sick pay and, for qualifying injuries, the industrial injuries scheme.
The employer's obligation is closer to accurate wage and absence data than a board-style claim file, so the record needs different content depending on which scheme it feeds.
How to complete it
How to complete a claim support record, step by step
The fields in this record are straightforward to complete. What determines whether it reflects genuine support, rather than a defensive paper trail, is judgement the form does not prompt for.
Incident reports, investigation findings and exposure records can be compiled to demonstrate the employer met the minimum, or compiled to give the claim its best chance. The difference shows up in completeness and speed, not the checklist, and is worth deciding deliberately.
A late employer report happens for reasons unrelated to reluctance: late worker reporting, an unavailable manager, a form sent to the wrong inbox. Recording the actual reason, rather than leaving the field blank or backdating it, is what makes the record defensible if queried.
Clinical detail belongs with occupational health, and the separation fields exist because an HR-written claim narrative too often drifts into describing the injury itself. A diagnosis appearing anywhere HR-visible means the boundary has already failed, regardless of what the confidentiality fields say.
A record that stops at submission has captured half the obligation. Decision, dispute, appeal and the return to work coordination that follows an accepted claim are where most of the ongoing cooperation duty sits, and closing early is the most common way this instrument understates what happened.
What auditors find
Most common claim support record findings
Findings against this record concern a file that looks complete while the underlying support was thin or defensive, rather than missing fields.
| Finding | Clause | What fixes it |
|---|---|---|
| Employer's report submitted late, with no reason recorded. | Workers compensation legislation — timeliness of employer submission | Record the actual cause of any delay at the time it happens, not after the fact. |
| Worker not assisted with, or the process not explained during, the submission. | WCB — duty to cooperate with the claim | Offer assistance and confirm the process was explained before the claim moves to submission. |
| Medical or health surveillance evidence compiled before consent for disclosure was obtained. | Health information / privacy legislation — consent to disclosure | Obtain and record consent before any clinical evidence is added to the file. |
| Independent advice not signposted to the worker at any point in the process. | WCB — duty to cooperate with the claim | Offer union, advocacy or legal signposting as standard practice, and record that it was offered. |
| Record closed at submission with no follow-through to decision, dispute or appeal. | Workers compensation legislation — dispute and appeal rights | Keep the record open and update claim status through to its actual resolution. |
| Return to work not coordinated with the insurer once the claim was accepted. | Workers compensation legislation — return to work cooperation duty | Log insurer coordination as a required step for every accepted claim, not an optional courtesy. |
Case in point
Case in point: the file that satisfied HR and lost the appeal
A warehouse worker's back injury claim was accepted, then disputed by the insurer eight months later over a gap in the wage data used to calculate benefits. HR pulled the claim support record and found every evidence field marked yes, with the submission filed two days inside the statutory deadline.
What the record did not show was that the worker had never been told the process, had not been offered independent advice, and had assumed for months the employer was handling the appeal for them. When the dispute went against the worker, it turned partly on whether the employer's cooperation had been genuine, and a file that evidenced paperwork but not support did the employer no favours before the board.
The template
The template, field by field
The form exactly as it installs. Every field, option, score and conditional rule is editable, and the links to other templates come with it.
4 sections
- Reference
- HLT-021
- Archetype
- Record
- Record ID
- CLM-2026-000
- Scoring
- Not scored
- Direction
- n/a
- Singleton
- No
- Basis
- WCB, workers compensation legislation
- Links
- Links Case, Worker
- Tags
- Health, Claim
- Sections
- 4
- Fields
- 40
- Follow up fields
- 0
- Repeating sections
- 0
- Links out
- 2
Header
16 fieldsRecord ID*
Auto sequence. Format CLM-2026-000.
The record's own ID. Other templates point at this value.
Status*
Drives who this goes to next.
- Planned2 pts
- In progress2 pts
- Complete3 pts
- Deferred0 pts
- Open0 pts
- Closed3 pts
- Overdue0 pts
Date and Time*
Completed By*
Site*
Site ID*
Format SITE-000.
Links to FDN-001 Site ID
Worker*
Person ID*
Format PER-0000.
Links to FDN-003 Person ID
Record Confidentiality
Clinical detail stays with occupational health. Management receives a fitness outcome and any restrictions, never a diagnosis. Restrict access to this template accordingly.
Clinical Detail Held Separately*
- Yes3 pts
- No0 pts
Access Restricted To Occupational Health*
- Yes3 pts
- Partly1 pt
- No0 pts
Worker Consent Obtained*
Consent to share the fitness outcome with the employer. Withdrawal is the worker's right.
- Yes3 pts
- No0 pts
Support The Person, Get The Facts Right
Claims processes are stressful and confusing. Helping somebody through it is both decent and practical, because accurate early information avoids disputes later.
Case ID
Thread key
Claim Type*
Workers compensation, insurance, statutory sick pay or third party.
Claim Reference
Submission
6 fieldsEmployer Report Submitted*
- Yes3 pts
- No0 pts
Submitted Within Deadline*
- Yes3 pts
- Late0 pts
Days To Submission
Worker Assisted With Their Submission*
- Yes3 pts
- Offered2 pts
- No0 pts
Process Explained To Worker*
- Yes3 pts
- Partly1 pt
- No0 pts
Independent Advice Signposted*
Union, advocacy service or legal advice. Offering it builds trust rather than undermining it.
- Yes3 pts
- No0 pts
Evidence provided
8 fieldsIncident Report Provided*
- Yes3 pts
- No0 pts
Investigation Report Provided
- Yes3 pts
- Not applicable3 pts
- No0 pts
Witness Statements Provided
- Yes3 pts
- Not applicable3 pts
- No0 pts
Exposure Records Provided
- Yes3 pts
- Not applicable3 pts
- No0 pts
Health Surveillance Records Provided
- Yes3 pts
- Not applicable3 pts
- No0 pts
Consent Obtained For Medical Disclosure*
- Yes3 pts
- No0 pts
Employment And Duty Records Provided
- Yes3 pts
- No0 pts
Information Accurate And Complete*
- Yes3 pts
- Partly1 pt
- No0 pts
Status
10 fieldsClaim Status*
Decision Date
Disputed
- No3 pts
- Yes0 pts
Return To Work Coordinated With Insurer
- Yes3 pts
- No1 pt
Worker Kept Informed Throughout*
- Yes3 pts
- Partly1 pt
- No0 pts
Premium Or Experience Rating Affected
Case Manager*
Signature*
HR*
Second Signature*
HLT-021 · record IDs look like CLM-2026-000 · Links Case, Worker
Open in KnowellaRun it with agents
From a document you fill in to a programme that runs itself
The record itself is a paper trail. What actually determines whether a claim goes well is whether the deadline was caught, the worker was kept informed, and the file was still being updated three months after submission.
Holds the claim support record against the underlying case and worker, and flags a submission deadline before it is missed rather than after.
Supplies the incident and investigation evidence this record needs from the safety side, so it does not have to be reconstructed from memory.
Watches claim status for records stalled at submitted with no update, and prompts return to work coordination once a claim is accepted.
This template lives in KnowHealth — employee wellbeing. Exposure monitoring, health surveillance, case management and return to work.
Meet KnowHealth→Glossary
Claim Support Record definitions and key terms
- WCB
- Workers Compensation Board, the provincial or state body administering injury claims, benefits and return to work obligations.
- Employer's report of injury
- The statutory notification an employer must submit to the board within a fixed deadline once a claim-eligible injury occurs.
- Experience rating
- A mechanism by which an employer's premium or assessed rate is adjusted based on their claims history, which is why claim outcomes have a cost consequence beyond the individual case.
- Duty to cooperate
- The employer's statutory obligation to provide evidence reasonably requested and to support return to work planning once a claim is underway.
- Consent to disclosure
- The worker's explicit agreement, recorded before the fact, that medical or health surveillance information may be shared to support the claim.
FAQ
Frequently asked questions about claim support record
Does this record replace the employer's statutory report to the board?+
No. The statutory report is a separate submission made directly to the board or insurer, on their form, within their deadline. This record tracks that it was submitted, when, and what evidence went with it.
Who should see the clinical detail behind a claim?+
Occupational health, and no one else by default. HR and management should see a fitness outcome and any restrictions, never a diagnosis, and the confidentiality fields exist to force that boundary to be stated rather than assumed.
What happens if the employer's report is late?+
In most schemes, late reporting is itself a compliance failure, assessed separately from the underlying claim. Recording the genuine reason for a delay matters more than making the record look timely after the fact.
Should the employer offer independent advice to the worker?+
Yes. Signposting a union, advocacy service or legal advice does not weaken the employer's position; it builds the trust that keeps a straightforward claim straightforward.
Does this record track the claim after it is accepted?+
It should. Decision date, whether the claim is disputed, and insurer coordination all belong in the same record, because the cooperation duty does not end at submission.
How does a claim affect the employer's premium?+
Through experience rating, in schemes that use it, where accepted claims can raise an employer's assessed rate over time. It is worth recording an expected premium effect even as an unknown.
Keep going
Related templates and programmes
Industries this is written for
Programmes this belongs to
Used together in Return to Work
Occupational Health Case Record
Records and tracks a health case from first report through to closure
Work Restriction Record
Records what a worker can and cannot do while recovering, and for how long
Modified Duty Plan
Sets out the temporary duties a recovering worker will perform
Case Progress Review
Reviews how a health case is progressing against its expected timeline
Case Closure Record
Closes a health case, recording the outcome and any lasting restrictions
Absence Trend Review
Reviews absence patterns by area, shift and cause category to find where work is making people ill
More in Case Management
Written and reviewed by
Siddarth Singh
Founder & Chief Executive Officer, Knowella
Certified Safety Professional and industrial and systems engineer with more than a decade inside food supply chain, freight and manufacturing operations. This page was written against the current text of the standards it cites, not against secondary summaries of them.
- Certified Safety Professional (CSP), Board of Certified Safety Professionals
- MBA, University of Chicago Booth School of Business
- MS and BS, The Ohio State University, Industrial and Systems Engineering
- Six Sigma Black Belt
Sources and last review. Reviewed 16 August 2026 against:
- Provincial and state Workers Compensation Board legislation — employer's report and cooperation duties
- OSHA recordkeeping requirements, 29 CFR Part 1904 (US)
- UK Statutory Sick Pay and Industrial Injuries Disablement Benefit framework (DWP)
- Health information / privacy legislation governing consent to disclose medical information
This page is general guidance, not legal advice. Confirm requirements with your jurisdiction’s regulator.