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What to Expect During the Workers’ Comp Claim Process

by Ali Raza
March 1, 2021
in Business, Lifestyle
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Career Corner: Can an Employee Be Terminated While on Medical Leave?

How to File a Workers' Comp Claim

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The private sector recorded 2.8 million workplace injuries and illness in 2019.

If you experience a workplace injury, you’re entitled to some form of compensation through workers’ compensation insurance. Workers’ compensation is mandatory for workers in every state except Texas.

If you’re injured during work, you have a short time to submit your workers’ comp claim, or it could be denied. If it’s your first time filing this claim, the entire affair might seem a bit convoluted. That’s why it’s a good idea to have a firm understanding of the workers’ comp claim process beforehand.

Today, we’ll be looking at what the workers’ compensation claim process involves and what you’ll need for a fair workers’ comp settlement.

Table of Contents

  • Step 1: It All Starts With the Employer
  • Step 2: Employer Furnishes You With the Paperwork
  • Step 3: You File the Claim
  • Step 4: The Insurers Gives the Verdict on the Claim
  • Step 5: Get Back to Work
  • The Workers’ Comp Claim Process Made Easy

Step 1: It All Starts With the Employer

As the name connotes, workers’ compensation benefits only cover work-related injuries. That’s why the first step of the process is to report the injury to your employer. However, if it’s an emergency, the employee should first seek medical attention before reporting to the employer.

The deadline for reporting the injury varies from state to state. However, for most states, the employee must give notice within 30 days of the injury. For states like New York, you have up to a year to report the injury.

Step 2: Employer Furnishes You With the Paperwork

Once you notify the employer of your injury, they should furnish you with the necessary paperwork required for the entire process. This paperwork includes:

  • Reporting forms for the workers’ comp insurer
  • Information on workers’ comp benefits and employee rights
  • Details on returning to work

The forms employers should give employees depend on the state in question. Failing to furnish employees with the right paperwork could lead to lawsuits.

Step 3: You File the Claim

Your employer should convey the necessary paperwork to your workers’ comp insurer. Sometimes your doctor also has to submit a medical report.

Depending on your state, you may need to submit information to the state workers’ compensation board. This is standard for all workplace injuries, even if you aren’t pursuing worker’s comp benefits.

Step 4: The Insurers Gives the Verdict on the Claim

Based on the information at hand, the insurer will either approve or reject the claim. You’ll probably need a workers’ comp lawyer at this point to help streamline the process. If approved, the insurer contacts the employee with the payment details.

If the insurer approves the claim, you can either accept the payment or negotiate for a lump sum settlement. If the insurer doesn’t, you can appeal the decision or ask for a review of the decision.

The insurer must inform the workers’ comp board of any decision it arrives at. A worker’s comp attorney will be instrumental in helping you secure a fair settlement.

Step 5: Get Back to Work

You must notify your insurer and employer that you have recouped sufficiently and wish to get back to work. There’s a chance that your workers’ comp premium will increase if you have frequent injuries on the job. Proper safety training is vital to help decrease worker’s comp premiums.

The Workers’ Comp Claim Process Made Easy

Hopefully, you now have a clear understanding of the workers’ comp claim process. Remember, it’s your right as an employee to receive compensation for any workplace-related injury or illness. However, you’re better off with a lawyer by your side to get a fair claim.

Hope this article will help you succeed in your claim. Keep reading our articles for more helpful tips and guides.

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