The Workers’ Compensation Claim Process: Everything to Know

The Workers' Compensation Claim Process: Everything to Know
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According to the US Bureau of Labor Statistics, there were three million nonfatal worksite injuries recently reported in the US. That means for every 100 full-time employees in this country, at least three were injured on the job.

Were you recently injured on the job? Read further for everything you need to know about the workers’ compensation claim process. Once that’s taken care of, you can focus on your recovery.

What Is Workers’ Compensation?

Workers’ compensation applies to individual state laws that guarantee employees injured in the workplace will receive reimbursement to cover their medical expenses. These statutes are in place so that employees won’t have to sue their employers for repayment.

Workers’ compensation specifically pertains to injuries sustained on the company’s property. Under present-day workers’ compensation statutes, nearly all companies can’t open for business until they’ve secured a workers’ comp insurance policy.

Every state has its own version of workers’ compensation statutes. That’s why you’ll find that these laws vary from state to state. There are also special compensation laws for employees in specific industries such as the railway industry or federal government.

There are more than 140 million US employees currently covered by workers’ compensation insurance. Total costs for workers’ compensation insurance to US companies is over $95 billion.

The first state-level workers’ compensation laws were passed in 1902. By 1949, all US states had ratified their own workers’ compensation laws to protect their workers.

Workers’ Compensation Claim Process Overview

Since every state has its own version of workers’ compensation laws, you can easily get confused if you’re filing a workers’ compensation claim. Each version, however, contains a basic version of these important procedural steps:

Get Medical Treatment Immediately

Be sure to seek medical attention as soon as you can after your injury. Check with your physician so that your injuries can be accurately diagnosed and treated at once. Outcomes from this visit will help you demonstrate that your injuries were caused by the accident.

Collect Proof

Evidence will play a vital role during the workers’ comp claim process. Take pictures of the accident site and your injuries. Write down the details and events leading up to your injury so that you’re able to preserve the facts.

Alert Your Employer

Tell your employer in writing that you have sustained an injury. State workers’ compensation laws will have statutory deadlines after your injury outlining how quickly you must inform your employer that you were injured.

When you do notify your employer about your accident, be sure to include the following details:

  1. Accident location, date and time
  2. How your accident took place
  3. Any other witnesses or individuals involved with the accident
  4. The extent of your injuries
  5. Status of the medical care you’ve received to date for these injuries

You will also need to include these details on your eventual workers’ compensation claim form, so keep a copy for your own records.

Hire a Lawyer

If you disagree with the insurance provider’s decision, hire a workers comp attorney to represent your claim. Legal help can lead your claim through the process so that you can concentrate on getting back your good health. They can also help negotiate a settlement if your claim is heading for the courts.

These professionals can collect the evidence necessary to dispute the insurance provider’s position. This evidence might include deposition testimony, which may include taking depositions, requesting a second medical opinion, or hiring an expert witness—all of which require legal expertise.

Workers’ Comp Claim Review

Submit your workmans’ comp claim to your company insurance provider as well as your state-level workers’ comp office. After your employer’s insurance company reviews your claim they’ll notify you to let you know if your request is approved.

Most employers file workers’ compensation claims with their insurance provider and the appropriate state workers’ comp board on your behalf. Once your claim is reviewed at the state level, a benefits specialist will let you know if your claim is accepted and how much payment you can expect to receive.

After the Claim

Most of the workers’ comp claim process is done once you fill out your claim paperwork. Be sure to keep a detailed record of your recovery.

For example, keep any receipts for your out-of-pocket medical costs. Record how your injuries impact your job or other daily activities.

Re-Opening a Workers’ Compensation Claim

Employees can also choose to reopen their closed workers’ compensation claim after it has been settled. You might want to reopen your claim if you start to experience delayed onset injuries that are attributable to your original injuries.

Delayed onset injuries won’t show visible signs or symptoms right away and can take a long time to turn into real pain. Whiplash and traumatic brain injuries are just two examples of delayed onset injuries.

Re-opening a claim depends on what settlement you and your employer agreed upon before the injuries came back. If you settled a “compromise and release” claim agreement, that means your case can’t be reopened.

If you settled your claim with a “stipulation and award” this means your case can be reopened under specific circumstances. Circumstances might include new proof that shows that your original agreement had miscalculations or other errors.

Next Steps for a Workplace Injury

If you were hurt on the job, seek medical attention as soon as you can. Your doctor’s diagnosis will be a focal point in your workers’ compensation claim.

Notify your supervisor in writing about the accident and any injuries you received. Create an accident file that includes pictures of the accident site and your own personal notes. You’ll need this information in case you start to notice delayed-onset injury symptoms.

If you have any lingering questions the workers’ compensation claim process, don’t forget to check out our website. We have plenty of up-to-date articles on how to navigate this process yourself. You can also find referrals to legal professionals that can help you through the process so you can focus on your recovery.

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