Workers' Comp Claims Process: All Your Questions Answered

Written by
Rebecca Smith

Published
May 20, 2019

May 20, 2019 • by Rebecca Smith

Have you suffered an injury while working? You may be eligible for workers' compensation.

With the rate of denied workers' compensation claims rising, you need to make sure you have what you need to file your claim. It can be a stressful process, and it isn't hard to miss something.

If you are looking for what you need to do to file, then you've come to the right place.

Keep reading below to learn about the workers' comp claims process and how to handle it to increase your chance for a successful claim.

What Is Workers' Compensation?

Companies try to keep their employees safe, but sometimes accidents happen. A company offers workers' compensation for when this happens. It is an insurance policy that a business can purchases that provides financial compensation for workers who are injured while on the job.

There are a few types of workers' compensation: rehabilitation, cash benefits, medical costs, and supplemental benefits. What you receive will depend on the type of injury, and the recovery process that happens after a doctor treats you.

What Is the Claim Process Like?

The whole process can vary by state law, but there are several steps that you need to take no matter what state you are in. Follow the below action items to make sure you keep everything in order.

Seek Immediate Medical Attention

Don't wait to seek medical treatment if you suffer an injury at work. Even if the damage is small, head to a medical professional to get treatment. Many policies require you to seek medical attention to file a claim.

Many workers' compensation policies also require you to see specific doctors to be eligible for filing. Make sure you ask someone in management about who to go to so you can file your claim after treatment.

Notify Your Employer

Whether it is when the injury happens or sometime after, you must notify your employer about the accident. If you wait too long, then you can jeopardize your claim. Many states have a time limit for workers' compensation claims.

Notify your employer in writing. While verbal notification might seem like it is enough, from this point forward, you want to make sure everything is in writing. This way, there is no miscommunication.

File Your Claim

Once you notify your employer, they should provide you with the forms you need to file your claim. If they don't, you can request a compensation form from your state workers' compensation board.

You want to provide as much detail as you can about your injury when filing your claim. Make sure you include all these details if they are available:

  • Date and time of the injury
  • The location where the injury occurred
  • Parts of your body that were affected
  • Anybody that was involved in the accident
  • Witnesses to the event
  • How the accident happened
  • Medical treatments for the injury
  • Any required rehabilitation to recover from damages

The more information you have to prove your claim, the better chance you have of winning. Make sure to document everything.

Once you finish, you can hand your paperwork to your employer, and they will send it to the insurance company to process the claim.

Your employer is then required to file a report with the state compensation board, and your medical doctor will need to send in their medical report.

Follow Up on the Claim's Progress

Once everything is submitted and under investigation, don't put it on the backburner. Keep following up on the process and document where it stands.

It is also a good idea to monitor your health during this time and keep track of how the injury is impacting your daily life and your ability to work.

If you have any other out of pocket expenses resulting from the injury, you should also keep track of those. This will help make sure that you receive the correct compensation when your claim goes through.

Negotiate Any Settlement

Once the insurance company has concluded their investigation, they will give you their verdict. This verdict can happen in two ways.

Approved Claim

If your claim is approved, you should receive an offer. This offer can cover your medical expenses, disability, and lost wages.

You have a choice to accept this offer or negotiate for a better one.

You can get your payment in two ways. If you decide for a lump sum, you will get your entire settlement at once. The insurance company can offer you a structured payment plan that pays your money out over some time.

Denied Claim

If your claim is denied then you still have options. You can request a review of your claim or file an appeal to the workers' compensation board for your state.

You don't have to rely on the insurance company or appeals board either. You have the option of bringing in a lawyer to help with the process.

Denials happen all the time, and people who bring in lawyers are often able to reverse the denial. Don't let your workers compensation claim go down the drain when there are people who can help you win.

How Long Does the Claims Process Take?

The good news is that state law mandates insurance companies look at your case within a reasonable amount of time. This time period can be between 14 and 30 days of your filing date. If an insurance company needs longer, then they are required to file an extension.

If the process takes too long then the insurance company can receive penalties. In some cases, your claim will be automatically approved.

Don't Miss Anything on Your Workers' Comp Claims Process

The workers' comp claims process can seem tedious and overcomplicated, but it's necessary to make sure you have everything you need to get what you deserve. Make sure you follow all the steps and don't miss a thing.

Has your injury cause problems that prevent you from doing your job? Take a look at our careers board to find jobs that you can do.