How long a workers’ compensation claim takes varies from situation to situation. Ideally, you would start receiving benefits within a few weeks of filing your initial claim. Yet, it could take longer if the insurer contests your injuries’ cause or severity.
If you suffered an on-the-job injury and want workers’ compensation benefits, you’re within your rights to partner with a worker's compensation attorney. While managing your case, they can avoid any delays and keep your case moving forward.
These Things Could Keep Your Workers’ Compensation Claim on Track
Typically, if everything goes according to plan, you should expect to receive workers’ compensation benefits in less than a month. Yet, this isn’t guaranteed. As an injured worker, you have some obligations that help your case progress, such as:
Immediately Reporting Your Injury to Your Employer
You must report your injury to your employer as soon as possible after the accident happens. Each state has deadlines for how long an employee has to report an on-the-job injury to their employer. For instance, if you live in South Carolina, you typically have 90 days from the date of your accident to notify your employer of your accident and injuries.
If you do not report your injury within the correct timeframe, you could lose your chance to receive workers’ compensation benefits. Once you report the injury, your employer can open a file through their workers’ compensation insurer.
Cooperating With the Insurance Company’s Investigation
After you file a workers’ compensation claim, the insurance company will review the circumstances of the injury. This involves reviewing the available evidence and then deciding on your claim. Workers’ compensation investigators can look for evidence in various ways.
- Review video footage: Many workplaces have cameras installed for security reasons and other purposes. When you get into an accident, the claims adjuster can review the video footage to see how the accident happened. Then, they can confirm you sustained your injuries while performing your job-related duties.
- Perform online surveillance: Investigators could monitor your online activity. Online surveillance could include looking through your social media and tagged photos. By getting this information, they could find out if your injuries are as severe as you claim.
- Interview witnesses to the accident: Investigators could interview those who witnessed the accident. They could ask witnesses if you exhibited symptoms of an injury before the accident.
- Interview your friends and family: After the incident, you could expect workers’ compensation investigators to interview your friends and family. They could ask about the extent of your injuries and how they impact your day-to-day life.
Workers’ compensation investigators conduct these investigations to ensure the injuries you sustained happened at work. If you hire an attorney, they can conduct their own investigation. Another look into how your accident happened could prevent the insurer from contesting your case.
Getting a Medical Evaluation
To receive workers’ compensation benefits, you must get evaluated by a medical care provider. They can diagnose your injury or illness. Without a diagnosis, your workers’ compensation claim could get denied.
Additionally, you must follow the treatment plan your medical care provider prescribes. Complying with their orders shows you have done what you can to improve your injuries. If you don’t follow the prescribed treatment plan, the workers’ compensation insurance company could deny benefits.
Issues That Could Delay a Workers’ Compensation Claim
While workers’ compensation claims typically resolve within a month, sometimes, issues can extend the timeline. When issues do arise, you could expect to wait longer to receive benefits. Some complications could include:
You Don’t Have Supporting Evidence
Even if your on-the-job accident seems straightforward, you still need evidence to support your claim. Some of this information may fall into your lap naturally. For instance, if your doctor gives you a written treatment plan, you could use this as evidence that you suffered injuries.
Other supporting information in your case could include:
- Testimony from accident reconstruction specialists
- Photos of any damaged property (such as a damaged vehicle)
- Eyewitnesses, including co-workers and healthcare providers
- Images of the accident scene from multiple angles
- The paperwork you submitted to the claims adjuster
- Receipts for any out-of-pocket expenses, such as temporary transportation arrangements
The more information to support your case, the better.
Your Claim Gets Denied
If your claim gets denied, you still have the opportunity to receive workers’ compensation benefits. An attorney can file an appeal on your behalf. Still, an appeal can significantly increase the amount of time your case takes. Once you hire an attorney, they can provide a more accurate timeline for your appeal. They can also strategize to seek the benefits you need.
If your appeal gets denied, you can expect your workers’ compensation claim to take even longer. If you want to continue pursuing your claim, you can take your case to court. Your attorney can advocate for you in front of an administrative judge. Then, the judge can decide whether to deny or approve your claim.
You Received Less Benefits Than Expected
If you received fewer benefits than you believe you deserve, you could benefit from the help of an attorney. They can evaluate your workplace accident injuries, and anticipated damages. Then, they can explain whether your benefits are fair.
Unfortunately, when you file a civil claim or an appeal for this reason, it can extend the timeline of your case. Yet, it could prove instrumental in getting the funds you need following your on-the-job accident.
You Can’t Quickly See a Medical Professional
Workers’ compensation claims commonly get held up because the injured party cannot schedule a fast doctor’s appointment. Healthcare professionals sometimes take weeks or months to schedule visits. If you cannot see a doctor within the insurer’s network, this could stall the claims process.
Once you hire a workers’ compensation attorney, they could help you find a medical care provider that could see you. By visiting a doctor promptly, you could get the workers’ compensation benefits you need.
You Could Seek Damages Through a Personal Injury Lawsuit
If you suffered an on-the-job injury due to another party’s negligence, you could file a personal injury lawsuit and recover compensation. How long you have to file your lawsuit depends on where you live, the type of accident you experienced, and other factors.
Some states allow for longer filing periods than others. For instance, South Carolina has a filing deadline of three years, while others only grant a few months. Adhering to your lawsuit’s filing deadline is critical if you want to file a personal injury lawsuit in conjunction with your workers’ compensation claim. Here, you could recover damages beyond what workers’ compensation covers, such as pain and suffering.
How a Workers’ Compensation Attorney Can Help You
If you choose to hire a workers’ compensation attorney, they can help move your case along. Not only can they provide information on how long a workers’ compensation claim takes, but they can also take other helpful steps, such as:
Reviewing Your Case
An attorney can first review your case and assess your claim. If you hire them before submitting your initial claim, they can add evidence and witness statements. These items could make your case stronger.
If you hire an attorney during the appeals process, they can first review why your initial claim got denied. They can then include any missing evidence or documentation needed in the appeal. Once they have included all of the missing information, they can advocate for what you need.
Providing Legal Advice
Getting legal advice from an attorney can significantly benefit your workers’ compensation case. For instance, when you first submit your claim, you might not understand the process and could miss including pertinent information. If this happens, you could receive a claim denial for something simple, extending the time it takes to get benefits.
An attorney can also provide legal advice on whether you should move forward with a civil case. If your initial claim and appeal get denied, you can file a lawsuit and go from there. With an advocate on your side, you don’t have to manage this process on your own. Instead, you can focus on moving forward and recovering from your condition.
Gathering Necessary Medical Documentation
To prove your injuries, your claim must include the necessary medical documentation, such as:
- Testimony from doctors indicating the extent of your injuries
- Diagnostic lab reports, such as X-rays
- Your treatment plan
- Any relevant medical records
- The names of your prescribed medications
Having all the medical documentation you need allows the insurer to fairly evaluate your claim. It could also prevent the claims adjuster from disputing your condition’s cause and severity.
If any discrepancy arises about if your injury happened at work, an attorney can interview witnesses. Here, they can get an account of what happened from different points of view.
Witnesses can corroborate your version of events and prove you sustained injuries at work.
Your lawyer may ask witnesses:
- Did the injured party appear injured before the accident happened?
- Did you witness the accident occur?
- Did you see what caused the injuries?
- Did first responders come to the accident scene?
By asking these questions, your attorney can glean further insight into your accident and possible benefits. Also, they can prove you suffered injuries at work——which is absolutely vital to your case’s success.
Negotiating With the Insurance Company
The liable insurer may offer benefits but not the amount you need. In that instance, your lawyer can learn the reason for the unsatisfactory offer and go from there. This may involve presenting more evidence to the claims adjuster. It may also involve going back and forth until both parties come to an agreement.
Representing You in Court
Sometimes, two parties cannot come to an agreement in a workers’ compensation case. When this happens, the injured party can file a lawsuit.
The benefits of a workers’ compensation attorney in this situation include:
- They can prepare your case with solid evidence and necessary documentation.
- They can determine how much compensation you deserve to recover and can advocate for that amount.
- They can communicate with the involved parties, so you don’t have to.
If you decide to represent yourself through this process, you could encounter legal barriers that could prevent you from getting the compensation you need. A workers’ compensation attorney knows how to navigate those challenges and fight for the best possible outcome.
What Benefits Does Workers’ Compensation Insurance Provide?
Most states require employers to carry some form of workers’ compensation coverage.
In these areas, if an employee suffers an on-the-job injury, they can file a claim through their employer’s insurance and recover:
- Medical care to treat the injury or illness: Regardless of how extensive the medical treatments become, you could receive compensation for them. Your injuries could require surgery or long hospital stays. With workers’ compensation benefits, you won’t have to worry about the financial ramifications of seeking medical care.
- Funds to replace your income: You could miss work for a short or long time. Regardless, workers’ compensation benefits could offer the funds you need to live. Without them, you could lose your house or vehicle. Workers’ compensation benefits prevent that.
- Permanent disability benefits. Depending on the severity of your condition, you could receive ongoing cash payments for up to 500 weeks. How much you can recover through disability benefits (and for how long) depends on your condition.
Some claimants file workers’ compensation claims on behalf of late loved ones. In that instance, you could receive death benefits, which would offer compensation to pay for your loved one’s funeral.
You Can Learn More About Your Workers’ Compensation Case Today
A workers’ compensation attorney can help you through the claims process and provide information about your case’s possible timeline. Knowing how long your workers’ compensation case could take allows you to plan accordingly. Because many personal injury attorneys offer free consultations, you can learn more about your case at no obligation.