When you’re hurt at work it’s best to file a workers comp claim. Workers’ comp is a type of insurance that can provide you with wage replacement and medical benefits if you’re injured in the course of employment. This is provided in exchange for mandatory abandonment of your right to sue. According to statistics, 3 workers comp claims are filed for every 100 full-time workers. According to the Bureau of Labor Statistics, roughly 18.4 million workplace injuries and illnesses were claimed in 2015. This averaged out to 5.1 cases to every 100 full-time workers.
Workplace accidents can happen anywhere at any time. Some of the accidents which fall underneath this umbrella include accidents associated with material handling, being struck by or colliding with objects, accidents involving tools, traumas that occur over time (when a part of the body is injured or overused or strained), and slips, trips, and falls. Here are a few tips on how to begin a workers’ comp claim.
Report the injury to your employer.
Once you’ve become injured, immediately report what happed to your employer. You don’t want a lot of time to lapse between the point of injury and when you notify your employer. If you let too much time go by, then there’s a good chance that you won’t receive timely medical attention which is important. Secondly not reporting your injury immediately can complicate your claim going forward.
In an emergency situation, say if you have dire spine conditions as a result of being hurt on the job, you might need to be taken to an emergency room. If the concerns are less immediate though, then after informing your employer of the injury, you can schedule a doctor’s appointment for further help. In many cases of injury at the workplace, you might suffer from neck pain, numbness, back pain, hip pain, pain across your ligaments, and general pain across different parts of the body. The doctor will be able to give a diagnosis, let you know your treatment options, and provide you with a medical report to be filed with the worker’s comp claim.
Some accident cases might involve physical therapy, surgery, or just a quick couple of visits to a spine specialist. Whatever the injury, or whether it needs to be treated by a neurosurgeon or spine specialist, it’s best that you visit a medical professional as soon as possible.
In some states, the time needed in which to report the injury can vary. For example, in New York, the employer needs to be advised within 30 days, while in some other states employers can wait up to one to two years to report an injury.
Document the injury.
When an injury occurs, your first thought won’t be to investigate the cause of the injury and take steps to record the evidence of the occurrence. Your immediate thoughts are probably along the lines of “Ow, this hurts,” or “Something about spine feels wrong” or “Let me find some immediate treatment for my body because it’s in pain”.
Only after telling your employer and seeking medical assistance do you want to do a proper investigation. You’ll want to first take a picture of the injury itself, to have documented proof that you were in fact injured. Get yourself the best photo storage app so that you can upload photos from your mobile device to a dedicated folder, and start taking pictures. Make sure your photo storage or mobile app has such features as a quality hard drive, premium storage space, megapixels, can make automatic uploads to your cloud storage, and contains at least 2GB of storage. Whether your smartphone is an android or iOS device, take as many prime photos as possible.
You don’t have to be a professional photographer to document these issues. Just click and shoot. These pictures can help you to document how your body was affected by the injury, and give proof that you were in fact hurt.
Also, go back to the scene of the injury. Take pictures of the environment to give as much context as possible as to what happened and upload photos of this to your photo storage folder as well. Maybe this particular area at your job has a history of work-related injuries. Maybe there’s a leaky pipe that always creates a wet floor, or maybe there’s an electrical short which creates a semi-darkened area that is difficult to navigate through.
This may seem like doing a lot, but you want to do your due diligence on this front. At the end of the day, it’s your word against your employer. You want to have a stable footing when presenting your evidence during the workers’ comp claim process. Give yourself some peace of mind and do your best to document the injury.
Receive the necessary paperwork from your employer.
Once your employer has received notification about the injury they are required to provide you with certain documents. These include (but are not limited to) the proper reporting forms for the workers’ comp claim insurance provider, a form for reporting to the state workers’ comp board, information on employee’s rights and workers’ comp benefits, and information about returning to work. If any of these forms are not received initially, follow up with your employer to receive them.
If you are receiving pushback for your form requests, then that might be the time to utilize the services of a lawyer. Law networks or firms like the WIN injury network can take the lead when you receive any form of push back from your employers about workers’ comp claim cases.
Make sure your employer files the claim.
Your employer is supposed to file the claim once you report it. The employer is responsible for submitting the claim to the worker’s comps’ insurance carrier. In addition to this, your doctor also needs to mail a medical report to the insurance carrier to go along with the claim. It’s the primary responsibility though, of the employer to be the one who files the claim.
In addition to this employers might be required to submit documentation to the state workers’ compensation board. In most cases, this applies to all workplace injuries, even if the employee isn’t seeking workers’ comp benefits.
Follow up with the insurance agency.
It’s up to the insurance agency to decide if a claim will be paid out. As the claimant, do your due diligence and stay on top of your case. Don’t hound the insurance agency endlessly (this might work against you), but try to stay on top of your case as much as possible. If the insurer approves the claim you will be contacted with the payment details. Normally in cases where payment is approved, then you can then accept the offer. This payment might cover the costs of medical bills, medicine, disability payments, and a portion of your lost wages
You can also negotiate for a lump sum settlement if the claim is approved. If the insurance agency doesn’t approve your claim, they will officially deny it. This happens because the insurer doesn’t think the claim qualifies for workers’ compensation benefits. In cases such as these, you can ask the insurance company to review their decision, and then you can appeal the case.
Head back to work.
With beginning the workers’ comp claims process your ultimate goal is to receive money to help you to get better. After that, your secondary goal is to get back to work. Once you’ve received the treatment needed to get back to your job, you must first notify your employer and insurance company that you are ready to come back. Even when you get back to work, depending on the severity of your injuries, the insurance company might continue to pay disability benefits.
When you’re back at work, don’t overexert yourself. Allow time to get acclimated to being back at work. Also, avoid those high-risk situations where there’s a chance that you might be injured on the job again.