Your Guide to the Workers’ Compensation Process

If you sustain a work-related injury, you will have a limited amount of time in which to report your injury and seek workers’ compensation benefits from your employer. It’s the responsibility of both the employee and employer to act quickly, or you could have your workers’ comp claim denied.

A majority of employers are required to cover workers’ compensation through insurance if an employee is injured on the job at any point. While employees aren’t required to prove fault in these cases to recover benefits, they will need to file a claim.

The workers’ comp process will vary depending on the state, but an employee will normally need to report the injury to the employer and the insurance carrier. However, the most important step is to seek treatment for any injuries that require medical attention.

The following are some of the specific steps you should take when filing a workers’ comp claim.

Seek Medical Attention for Injuries

Prior to filing a claim, always seek treatment from medical professionals if you require it. Even if an injury doesn’t seem serious, it could develop into something potentially life-threatening at a later date, so it’s often best to seek immediate treatment following any workplace accident. You may also need to seek medical attention to file a claim regardless of the nature of the injury, depending on your policy.

Keep in mind that you may need to visit a facility that’s designated in your workers’ comp policy, so you may need to review the policy or consult your employer to determine where you need to go for treatment. If you aren’t content with the first doctor’s opinion, you may be able to seek a second opinion from another professional.

Your medical records will help prove that you sustained your injury as a result of a work-related accident, which can help support your claim when seeking benefits.

Let Your Employer Know About the Injury

Once you’ve sought treatment for your injury, you should notify your employer if you haven’t already done so, as you will have a specific deadline to report the injury. In some states, you will only have a window of a month in which to notify your employer, so it’s important to report your injury as soon as possible.

You will need to notify your employer in writing, with a detailed description of the injury and any treatment you received. While you can also notify your employer verbally, a written description will always be a requirement when filing a claim. Written notification may be able to help support your claim and maintain consistency of details.

In turn, your employer should also provide you with a claim form to help initiate the claims process. If you don’t receive a form, request one from your state’s workers’ comp board.

Details to include in the written description to your employer should include:

  • The specific type of injury you sustained and the location of the injury on the body
  • Individuals involved in the injury
  • The time, geographical location, and date of the injury
  • The nature of the accident and how it happened
  • All medical treatment you received following the injury

What Is the Employer Responsible for in a Workers’ Comp Claim?

If your employer is required to provide compensation for any work-related injuries in which the worker wasn’t at fault, the company could face fines, lawsuits, and criminal charges if it fails to comply. Employers are also prohibited from retaliating against workers who claim workers’ compensation.

In most cases, an employer files a claim with the workers’ compensation carrier along with the state’s workers’ comp board office. Once the insurance carrier has reviewed the claim, you will receive a notice indicating whether the carrier has chosen to approve or deny the claim. If the carrier approves your claim, it will also disclose the total amount for which you may be compensated.

What to Do After Filing a Claim

Once you have filed all the necessary paperwork associated with a workers’ comp claim, you won’t need to perform many other actions. However, you should follow up for an update on the status of your claim and ensure that all records are consistent and accurate.

You may also want to keep track of how your injury affects your daily life in a journal, or keep track of any repeating doctors’ visits and ongoing treatment. Receipts and other proof of the costs associated with your injury can also be used to support your claim.

If the workers’ comp insurance carrier chooses to deny your claim, you are typically allowed to appeal the decision.

Work with a Workers’ Compensation Attorney for Additional Assistance

In many cases, a workers’ compensation claim and the ensuing process can be complex and stressful to navigate, particularly for those who are trying to recover. If you would like some assistance with the process, consulting with a workers’ comp attorney prior to filing a claim may be in your best interest.