When you or a loved one are injured at work, a plethora of thoughts probably race through your mind: worry about the severity of your injury; worry about your job; panic about paying your bills; etc. Filling out a workers’ compensation claim form may not be the first thought that comes to your mind.
But it needs to be and here’s why:
Filing a workers’ compensation claim as quickly as possible preserves your rights and gets things moving to ensure that you and your family are financially safe. The sooner you file your claim, the sooner your employer’s insurance will start paying your medical bills and some or all of your income.
But how do you file a claim? There are five simple steps to filing your claim.
Step 1: Report your injury
Many state laws indicate that you have four days after sustaining an injury to report it to your employer. You must make this report in writing. A verbal comment to your boss is not sufficient.
Check with your employer to find out if they have a form or just need a written statement from you. If your injuries are too severe for you to report them yourself, you should have a friend or relative report it on your behalf.
Step 2: Seek medical care
Even if you feel that medical care isn’t necessary, you should still see a doctor. Injuries that may seem minor initially can quickly become major.
Your employer should have a list of medical providers that are authorized under their workers’ compensation insurance. Choose one of the providers on this list to ensure that the insurance covers your claim. You will use this provider for the duration of your claim, for any and all injuries related to the claim.
If your employer doesn’t have a list of providers, you can choose your own. However, in this case, you should consider talking to a lawyer first. The provider you choose will have significant influence over the benefits you receive in your claim, so you want to make a good choice to ensure you get everything you’re entitled to.
Step 3: Your employer reports your injury to their insurance
Within 10 days of your initial report of the injury, your employer must report it to their insurance company. If your injury is severe enough that you have missed (or will miss) three days/shifts or more from work, then your employer may also be required to report it to your state’s Division of Workers’ Compensation.
These timelines are critical to ensuring that your claim is approved, as well as ensuring that your benefits are provided to you in a timely fashion, so that you face as little disadvantage as possible. You should ensure that your employer stays on top of reporting your claim. Ask a friend or relative to check on it, if you are unable to do so.
Step 4: Insurer accepts or denies the claim
Once your employer reports your injury, the insurance company has 20 days to accept (Admission of Liability) or deny (Notice of Contest) the claim. The most common reasons a claim is denied are that the insurer doesn’t have enough information about the incident or your injuries or they believe that the injury is not work-related.
Make sure you receive a definite answer of acceptance or denial. Injuries can crop back up weeks, months or years later, and if you do not get a definite answer now, you may find you’re unable to obtain benefits for the same injury in the future because the insurer will claim they never officially accepted or denied the claim.
Step 5: What happens if they deny the claim?
A denial does not mean all is lost. You can fight it.
You don’t want to fight it alone, though.
If your claim is denied, your first step should be to seek expert legal counsel. A qualified lawyer can help you file a Claim of Compensation and gather evidence. They will also help you interpret evidence from the insurance company and try to settle the case before it needs to go before a judge. This process can take anywhere from 4-12 months (minimum) but it’s important that you not give up.
Work-related injuries can be scary and intimidating. By following these steps, you’ll protect yourself and your future.