What to Expect When You File for
Workers’ Compensation?

A workplace can often turn dangerous if there is neglect or carelessness on the part of the employer. In fact, most of these injuries occur in non-construction companies, contrary to what most believe it to be. In case you have been injured at your workplace and are looking to file a workers’ compensation claim, here is what you can expect once you have filed the claim.

Who Can File for Workers’ Compensation?

To file for workers’ compensation, you must:

• Be an employer, and not a contractor, of the organization.
• Have been injured while you were at work.
• Be part of an organization or company that offers workers’ compensation policies.

Rules to Follow When Filing a Workers’ Compensation Claim

While filing for workers’ compensation is indeed an important step, there are a few more rules that you must abide by while filing for the claim. Failure to comply with any of these rules may lead to a backlash in your claim process and cause delay or a denial of the claim.

Here is what you must do if you have suffered an injury at your workplace:

• First, it is of utmost importance that you get immediate treatment for the injury you suffer at your workplace. Waiting too long can work against you, with no sure proof that the injury has occurred when you say it has.
• Do not wait too long to notify your employer about the injury. Instead, make sure the employer is made aware of the injury within 30 days from the date of the incident.
• Gather every medical proof you can, from the injury’s impact on you to the extent of the injury. All of these records can help prove the severity of the injury and whether it has rendered you incapable of continuing work while you recuperate.

The Filing of the Claim

Filing a workers’ compensation claim is just one part of a very lengthy process. Once you fill out the details, the claim is then sent to your employer, who also needs to fill out certain details and sign the claim. Only when both parties file the claim involved it is forwarded across to the workers’ compensation commission. These could either be part of the organization you work for or be employed by an insurance company.

Ideally, you keep a copy for yourself when you send the claim to the commission that would review your claim.

The Acceptance or Denial of the Claim

Once your claim is submitted to the workers’ compensation commission that looks after these claims for your employer, the claim will be reviewed by them. Here’s what would happen for each outcome.

In Case of acceptance:

If the commission accepts your workers’ compensation claim, the entire expense for the injury will be covered by the employer, from medical bills to your wages. In addition, once the approval is received, you will be provided medical care for the injury paid for by your employer.

In Case of Denial:

If the commission denies the claim, you will be given a letter from the commission that states the reason for the denial. Of course, you can always contest their verdict to take the claim forward before the court.

Possible Reasons for a Workers’ Compensation Claim Denial

More often than not, the disputes are resolved through arbitration. However, there are several reasons why the insurance carrier may deny your claim, refusing to provide the benefits owed to you. Some of these reasons include:

• Failure to report the injury to the employer within the stipulated time.
• Lack of evidence to prove the accident happened in the workplace.
• Refusal on the part of the victim to visit the doctor for a checkup of the injury.
• Pre-existing wound or injury of the body part that has been injured during work.

What Must You Do in Case of a Denial?

The final decision of whether your claim is approved or denied lies with the Workers Compensation Commission. However, you can approach the commission in case of a denial by sending them a letter stating that your claim is taken forward for a trial. Your workers’ compensation lawyer can help you through the process and point you in the right direction, along with ensuring that you have all the necessary data to get your claim approved during a trial before the court.

If you have suffered at your workplace, you must bring it to your employer’s notice at the earliest and find yourself a good workers compensation attorney who can help explain the way forward to you. In addition, ensure you seek immediate medical attention and find yourself a lawyer who has expertise in this particular domain.

You can also opt for a free claim review to help you understand how to go about filing your workers’ compensation claim.