Most companies are required by law to carry workers’ compensation coverage. This coverage is designed to support the employee in case of accidents or difficult aftermath of a workplace injury and handicaps as well as to save the employer from being sued. For the employee to seek compensation, they must lodge a request with their employer. The workers’ compensation system is part of the legislation of every state. Though the comp coverage may vary from state to state, they tend to share in several common features that serve to distinguish workers’ compensation benefits from other forms of financial compensation available.
If you were injured at work, your first course of action should be to seek medical attention as soon as possible. It is also needful for you to proceed with the claim process as most state legislature provides employees with a limited window of time to do so. Once this time is over, you may no longer file for worker’s comp.
What Is Workers Compensation?
Workers Compensation is a set of state laws for taking care of employees who are injured while performing work-related tasks. Most states require nearly all employers to carry workers’ compensation insurance. In some states legislation, any company with more than three employees must provide this coverage.
What exactly is covered?
Although benefits do vary in line with state laws, in general, it covers the cost of medical treatment, rehabilitation, damages for temporary and permanent disability, and lost wages. In the case of death from a work-related accident or occupational disease, the surviving family members such as a spouse or any next kin may be entitled to death benefits on behalf of the deceased. Moreover, if you can work, but not at the same job, your employer is usually required to give you another job you can do, if one exists at the company.
Workers’ Comp Claim Process
- See a doctor
The first step you should take is to see a health practitioner before filing a workers’ comp claim. Try and get the best immediate medical relief at your disposal. Injured workers are advised to first seek for immediate medical attention; the doctor will give you a diagnosis and a medical report, both of which you will file with the workers’ comp claim.
Seeking medical attention is a necessity, even if you don’t feel like getting one. Besides most states permitting the employee to seek a medical opinion from any choice doctor, most workers’ comp policies and insurance do make use of specific health personnel.
- Report to your employer
For you, an employee to seek reimbursements, you must lodge a request with your employer. Workers’ comp legislation comes with a statute of limitations in almost all states. This allows a given time frame for every injured worker to prepare their claim. Once this period is over, the employee may no longer file for worker’s comp. This is why it is advisable to tell your boss immediately when you need to get compensation because of the work-related accident. To make sure your company gets this inquiry, submit it in writing, and be sure you hold on to a dated duplicate.
- Get the needful papers from your employer
After notifying your employer, he will provide the necessary paperwork needed to file the claim. As a matter of fact, most states’ laws require the employer, doctors’ offices, and hospital emergency rooms to have the needful forms to kick start the process. The forms required of your employer to present to you should contain reports to the workers’ comp insurance provider, the state’s workers’ comp board, employee’s rights, and workers’ comp benefits.
However, the employee should be aware that all injuries must be work-related. Any injury that is out of space in the working environment or course of discharging duties is not to be considered. Accidents that are more acceptable in the workers’ comp clause include exposure to toxic substances, slips or falls, and other illness that can be traced to the working environment.
- Fill and return the form immediately
When filling out the workers’ compensation claim form (known as Form DWC-1), complete only the “Employee” section. Endeavor to SIGN and DATE the claim form properly. Keep a copy of the claim form for your records; you never can tell when the need might arise. Send the comp claim form back to your employer, as he will be the one to forward the form to the concerned insurance company. You may mail it back to him or hand-deliver the forms back. In the event of opting to mail, use the requested certified mail-return receipt.
You’ll most definitely like to go for the assistance of a work injury attorney. While the compensation claim is based on you and your injuries, an attorney performs its obligation in the legal aspects. With the lawyer help, your claim will be properly filled and get to the concerned insurance firm on time. Also, your questions in regards to your options will be pacified. In case the insurer denies the claim, your attorney will be there to help you appeal and get the right judgment. Having a proficient attorney working for you can certainly help in many ways, and the truth is, workers’ compensation cases are often notoriously tough without them.
- Await the insurer response
The insurer will make the final determination once the claim is filled. The job to accept or deny the claim solely rests on the insurer. If the insurer approves the claim, the insurance company will reach out to the employee and make the required payments or negotiate for a settlement. On the other end, if the insurer doesn’t see any need to qualify the workers’ claim, ultimately denying the claim, the employee can demand revision from the insurer or in most cases, appeal in the court of law.
After the employee must have been settled and the needful payments made by the insurer, the employee must notify both the employer and insurance company via written notice about his health status before he will resume work.
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