What is a Workers Compensation Claim: The Ultimate Guide

What is a Workers Compensation Claim: The Ultimate Guide 1

You were injured on the job. You know about workers compensation claims, but you have no idea where to begin.

What is a workers compensation claim? It’s an insurance claim you’ll file at your place of employment. Your employer’s insurance company will provide compensation. Most employers must carry a workers compensation plan.

If your employer doesn’t have a workers plan, you still have the right to take them to court. Regardless, an experienced attorney can help you get the compensation you deserve.

This article will explain how to file a workers comp claim in greater detail. Read further to know more.

Workers Compensation Claims Process

You should report the injury to your employer as soon as possible. Most states require you to report an injury within 30 to 45 days. Reporting your injury at the last minute can damage the credibility of your claim.

Report your injury to anyone in a managerial position. The higher-up should provide a workers compensation form for you to fill out. From there, your boss will submit the paperwork to your state’s workers comp board and the insurance company.

In other cases, you may fill out workers comp paperwork at the doctor’s office. Your doctor will provide the form, and you’ll notify your employer about the injury.

  • Note: Follow up with an employer after they filed the report with the insurance company. In some cases, employers will delay the process, or they won’t file your claim intentionally.

The insurance company will provide medical compensation, including a portion of your weekly home. You’ll typically receive around 66% of your total income while you’re on disability.

The Approval Process

Filing a workers compensation claim doesn’t mean you’ll get automatic approval. Above all, insurance companies want to save money.

This means they’ll find loopholes to minimize or reject your claim. That’s why a workers compensation attorney is invaluable.

They know the tricks insurance companies use to deny claims. Insurance companies are more likely to treat you fairly with an attorney at your side.

The same can be said for your employer as well. Employers may try to dissuade you from filing a claim.

Collecting Evidence

To win your claim, you must provide compelling evidence. The evidence must be irrefutable. The best pieces of evidence entail:

  • Medical Reports: Your doctor will document your injuries extensively. The doctor can link your injuries to the accident. Insurance companies will have trouble disputing the validity of a doctor’s report.
  • Medical Bills: Include all medical invoices with your claim. You’re entitled to medical bill compensation.
  • Paystubs: Provide documents noting your wages. This will help insurance companies determine the lost income as you recover.
  • Accident Report: This is the incident report you’ll complete after the incident. This is proof showing the accident occurred.

Eyewitness testimony is helpful as well. Contact anyone who witnessed the accident.

The witnesses can be co-workers or anyone who witnessed the accident. If they allow it, ask if you can record the conversation.

You can also enlist the help of medical experts to support your claims. Your attorney can hire medical experts to give testimony about your injuries. You can ask physical therapists to validate your claims as well.

If your injuries require physical therapy, note it in your claim. You may be entitled to additional workers compensation insurance for physical therapy.

An occupational expert will also be helpful, especially if you sustained crippling injuries. The expert can explain how the injury inhibits your ability to fulfill your normal duties.

Compensation Duration

When it comes to the claims process, the duration depends on state guidelines. Some states impose a 15-day deadline, and other states may have a 21-day requirement. In many cases, you’ll receive a response in two or three weeks after submitting a claim.

The duration of the compensation depends on state law. Some states cap the duration between three to seven years. In many cases, there’s no official cap, but your benefits may end when you reach 65.

For lifelong injuries, you may qualify for a life pension plan under the compensation program. If you have lifelong injuries, you may have a choice between routine payments or a lump-sum payment.

However, this option depends on state law and the insurance plan. If you’re dealing with a severe injury, talk to your attorney to see which payment plan is the best option for you.

The Role of an Attorney

A workers comp attorney can expedite the claims process. Your claim may undergo a delay if the insurance carriers are contending with an understaffed work environment. In other cases, the insurance carriers may ask for more time to investigate the claim.

You’ll also deal with comp investigators who may question the nature of your injuries. Lawyers will help you gather the necessary evidence to counter unwarranted claims made by investigators.

Also, an experienced attorney will be useful if you’ve never filed a claim before. They know what to expect and can help you avoid unnecessary delays. Above all, find an attorney who specializes in workers comp cases.

What Is a Workers Compensation Claim?

If you’re wondering, “What is a workers compensation claim?”, it’s a form of insurance that will cover your medical expenses and lost wages.

The duration depends on the nature of your injuries and state law. Winning a claim requires compelling proof in the form of medical bills, pay stubs, and accident reports.

Remember: the primary goal of an insurance company is to save money. Therefore, rely on a workers comp attorney to maximize your claim.

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