Claims, Audits & Coverage: What to Expect With Workers’ Comp

Workers’ compensation is one of those things most business owners hope they’ll never need to deal with—but absolutely need to have in place. And when something does happen, the last thing you want is to be figuring it out on the fly.

From setting up coverage to handling a claim or preparing for an audit, there’s a lot to stay on top of. The good news? You don’t have to manage it all alone.

Here’s what you can expect across each phase of the workers’ comp process—and how CadenceHCM is here to help make it simpler, cleaner, and way less stressful.

Step 1: Setting Up the Right Workers’ Comp Coverage

What You’re Responsible For

When you’re getting started with workers’ comp, you’ll need to:

• Choose a policy based on your industry and employee roles
  
  
• Provide accurate payroll estimates
  
  
• Classify employees correctly using risk-based codes
  
  
• Keep certificates of insurance for any 1099 contractors
  
  

Most states require coverage as soon as you hire your first W-2 employee. Getting this right on day one avoids penalties and legal issues down the road.

How CadenceHCM Helps

CadenceHCM makes setup easy by:

• Reviewing your business structure and helping select the right class codes
  
  
• Integrating workers’ comp with your payroll system to keep everything aligned
  
  
• Offering “pay-as-you-go” options so your premium adjusts automatically with your actual payroll
  
  

No guesswork. No overpayments. Just solid coverage that scales with your business.

Step 2: Handling a Workers’ Comp Claim

What Happens When an Employee Gets Hurt

If someone on your team gets injured on the job, here’s what generally happens:

1. You report the injury to your insurance carrier as soon as possible
   
   
2. The employee gets medical treatment and submits a claim
   
   
3. The insurance provider investigates and approves or denies the claim
   
   
4. Payments (for medical, lost wages, etc.) are made directly to the employee or provider
   
   

Even straightforward claims can feel messy if you’re not familiar with the process.

How CadenceHCM Supports You

When you work with CadenceHCM, you’re not left guessing. We’ll:

• Guide you step-by-step through the claims process
  
  
• Ensure all required documentation is in place and submitted on time
  
  
• Help you communicate with the carrier to avoid unnecessary delays
  
  

And because we handle your payroll and employee records, we can provide the data insurers need to move the claim along faster.

Step 3: Preparing for a Workers’ Comp Audit

Why Audits Happen

At the end of every policy period, your insurance company will perform an audit to compare:

• The payroll you estimated vs. what you actually paid
  
  
• The roles your team performed vs. how they were classified
  
  

If your payroll was higher than expected—or if roles were misclassified—you could owe additional premiums. If you overpaid, you might get a refund.

How CadenceHCM Makes It Easier

We simplify audit season by:

• Keeping detailed, accurate payroll records
  
  
• Helping you track employee role changes or duty shifts during the year
  
  
• Providing reports and audit support directly to your carrier
  
  

Instead of scrambling to pull together documents and worry about errors, you’ll be prepared and confident.

You Don’t Have to Handle Workers’ Comp Alone

Workers’ comp is a critical part of protecting your business and your team—but it’s not something you should have to become an expert in.

CadenceHCM helps you handle every step: from setting up the right coverage to managing claims and preparing for audits. We’re here to make sure things are done correctly, on time, and with your business’s best interest in mind.