Workers’ compensation is a policy that provides monetary benefits to workers who have suffered an injury or illness at their workplace. Be it a forklift accident or exposure to toxic chemicals, state statutes and regulations mandate companies to mitigate the financial burden that results from any workplace-related injury.
While accidents could occur in even the safest of office work environments, certain places such as construction sites, factories, and warehouses have a higher risk of causing injury or harm to workers. As such, workers’ compensation covers the immediate medical expenses, rehabilitation cost, and any lost wage or income for any employee who gets injured or sick at their workplace. So how can an employee successfully file a claim for compensation benefits?
Report the Injury
To begin with, the employee must report the injury to the employer immediately. The moment an incident occurs, it is essential for the worker to inform their supervisor about it. If you heal as time passes, it may become difficult to prove to your employer that you went through an incident, making you ineligible to receive any compensation or benefits.
Many states have time limits to report the incident to the employer and file a claim to receive benefits. Failing to do so immediately or within a specific time required by your particular state laws can delay or even deny you your workers’ compensation benefits.
Seek Medical Assistance
An equally important step is to seek medical help by visiting a doctor, as any delays may put your health at further risk. It is important to be honest about how the injury occurred, and specifically state that it happened at the workplace. Some companies have their preferred doctors as part of their compensation policy, so it is better to consult your employer regarding where to receive treatment.
You will consequently receive a detailed medical report from the doctor regarding your injury, which you will be able to officially use as documentary evidence about how and when the injury happened and have your workers’ compensation claim approved swiftly.
Fill Out the Required Paperwork
Having sought medical treatment and reported the injury, a worker can officially file a claim for compensation benefits. The employer will provide the worker with the appropriate forms, typically requiring detailed information about how and where the injury occurred and the nature and severity, and other details regarding the incident. It is crucial to be consistently accurate with your statements. Having one thing stated on your employer’s paperwork and the other on medical records will not help your case much; insurance companies often deny people their claims due to conflicting statements.
File the Claim
After filling out the report, the employer will proceed with filing the claim on your behalf with their insurance provider and the particular state’s workers’ compensation board with the accident report and medical documentation. The insurance provider will evaluate the claim to determine whether the worker is entitled to receive workers’ compensation benefits and inform the employer about it. If approved, the compensation may cover expenses such as medical bills, lost income, and more.
What if the Claim Gets Denied?
For many, getting the compensation they rightfully deserve sometimes is a cumbersome process due to various reasons. At times, they even get denied their legitimate compensation claim. In such cases, workers have the option to appeal to the insurance provider to review their decision. While many employees receive compensation benefits without any hiccups, there are also instances when litigation is needed, such as when the employer or insurance company disputes your claim. There could be a time where your injury is so severe that your employer or states’ workers’ compensation board contests your claim due to costly medical bills and rehabilitation expenses.
Also, there may be a situation when your employer asks you to return to work when you have not fully recovered and risk further damage to your existing health. In any of these cases, it is helpful to consult an experienced attorney to claim your unrightfully denied benefits as well as other employee rights.
While most companies today have rigorous workplace health and safety policies to safeguard their employees from any hazards and reduce their liability for workers’ compensation, some incidents are just unavoidable. Workers’ compensation as such is a mandatory requirement in all states for any business that employs workers. Thus, an employer is legally and ethically responsible for compensating its employee for any unfortunate workplace-related incident regardless of fault. If ever you find yourself in this situation, the above tips are your guide for a successful claim.
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