Workers’ compensation – often referred to as workers’ comp – is an insurance policy that provides coverage for employees who are injured or contract an illness on the job. It helps cover an employee’s medical costs, lost wages, and other related expenses while preventing legal action against the employer.
There are specific steps to take, guidelines to follow, and deadlines to meet when filing a claim. Understanding these rules and deadlines is one of the best ways to increase the chances that your claim is approved.
How to File a Workers’ Compensation Claim
Get immediate medical attention. This should not be put off at all. Go to the nearest emergency room or urgent care facility. Be sure to collect and keep any documentation you receive.
Report the injury to your employer. Each state has a different deadline for when this should be done, but it is usually 30 days or less. In some, it can be as little as a few days. The best move is to inform your employer as soon as possible after the injury occurs.
Fill out the workers’ compensation form. After reporting your injury to your employer, he or she should provide you with all of the necessary forms. You should fill out these forms immediately so that your employer can turn them into their insurance company. Some states require that you also file a claim with the state’s workers’ comp agency. Typically, an employee has up to a year to complete this step, but the deadline can vary from state to state. Filing as soon as possible prevents any missed deadlines.
Wait for claim approval or denial. The insurance company completes an investigation. Among other things, it checks to ensure your injury did not occur due to any of the following:
- Activities against company policy, such as fighting, drugs, alcohol, and other uncovered events
- Self-inflicted accidents
- Psychiatric conditions
- Accidents commuting to or from work
- Not following safety procedures
If the insurer feels any of these are to blame, your claim will likely be denied. Otherwise, the claim should be approved. You should know one way or another within two to four weeks.
When to Hire an Attorney
If your claim is denied and you are certain it should have been approved, you can appeal the insurance company’s decision. At this point, it is best to consider hiring an attorney. Appeals can be complicated, overwhelming, and involve many moving parts. Attempting to handle it on your own might result in the claim denial being upheld.An attorney can provide a lot of help. They can gather the evidence necessary to fight the denial, represent you in court, negotiate with the insurance company, and often get a favorable settlement. Additionally, attorneys typically only charge you if you win, and then it is only a percentage of what you are granted.