Injured at Work? Understanding the Workers Compensation Process
In 2018, there were 5,259 fatal work injuries in the US, a 2% increase from 2017. Despite the safety strategies embraced in all industries, workplace injuries are commonplace in most sectors. Occupational injuries can be fatal or nonfatal.
Regardless of the nature of an employee’s injury, workers’ compensation is necessary. Yet, an employee has to follow the right workers’ compensation process to receive the benefits. If you fail to file your claim within the stipulated deadline, you might not benefit from workers’ compensation.
Workers’ compensation process might seem complex if you’re unsure of the steps to follow. Keep reading to know what the workers’ comp claim process involves.
Table of Contents
Seek Medical Attention
The first and most crucial step after a workplace accident is getting immediate medical help. Whether the injury seems severe or not, seeing a doctor shouldn’t be negotiable. You need to consult with your supervisor as some policies have specifications on the doctor an injured worker ought to see.
About 9.5% of all deaths in the US stem from medical errors. Besides working with the specified doctor, you can seek a second opinion if unsatisfied with the first diagnosis. The medical report acts as an official record, and you might want to get it for your workers’ comp claim to be successful.
Report the Accident to Your Employer
Different states have set out the statutory deadlines within which you ought to report the deadline to your employer. The best time to notify your boss is soon after the occurrence of an injury. It is advisable to report a workplace accident even when you don’t have visible damage.
Your injury notice should be in writing. A written notification is an official record that will prove useful during the claim process. What’s more, making a written notice soon enough allows you to recall details involving the accident.
After receiving the accident’s notification, your employer will give you the workers’ comp claim form. You’ll need to indicate on the form all details regarding the accident, from the injury type, to the medical treatment received.
Keeping records even after filling the necessary paperwork is essential. More importantly, have a journal to record your daily struggles after the accident. You can further keep receipts for expenses emanating from the injury, which can help you during the appeal in case your claim is rejected.
Your Employer’s Role in Workers’ Compensation Process
An employer ought to give the injured worker the right reporting forms. The information you receive should also detail workers’ rights and compensation benefits. At this point, your employer should also notify you of how to go about resuming work.
States have varying requirements, and your employer should provide you with forms that are consistent with your state, the insurer, and the type of injury. Preferably, this information should be made available to an employee before seeking treatment. An employer who doesn’t provide the information risks lawsuits.
Your employer should submit the relevant documents to the board office and the insurer. The doctor attending to you after the accident should also send a medical report.
Insurer’s Response to the Claim
After reviewing the details on a worker’s injury, an insurer can decide to deny or approve the claim. The insurance company will give you the payment details after claim approval.
At this point, a workers’ comp claim process is between the injured employee, the insurance company, and in most cases, a legal representation.
The insurer might offer to cater for the medical cost, drugs, lost wages, and any resultant disability. Depending on the extent of the accident and the implications, a worker can choose to negotiate for better repayments.
You don’t have to take no as the final answer. You can appeal the decision of the insurer. You can also negotiate with the insurer to review the decision.
Get Legal Assistance
Failing to get your rightful compensation wouldn’t be surprising. Many employers and insurance companies tend to deny injured employees their comp claims despite their legitimacy. While some workers navigate through the hurdles alone, others give up as the process can be daunting.
Hiring a workers’ compensation attorney gives you a better chance of getting what is rightfully yours. A professional attorney will gather relevant evidence and negotiate with the insurer on your behalf. With the right lawyer, you don’t have to worry about the hearing or to get a reasonable settlement from an insurer.
If your employer and insurer are cooperative in compensating you after a workplace accident, hiring an attorney is unnecessary. However, you need to be wary of any retaliatory actions from your employer. Get an attorney as soon as you realize your workers’ compensation process is facing complications.
Returning to the Workplace
Once you recover fully, write a notice to the insurance company and your employer. You need to state when you plan to return to work. If you’re still facing the implications of the accidents, the insurer might have to continue paying disability fees.
The more an employee suffers from occupational injuries, the higher the premiums rise. This situation can be costly for both the insurer and the employer. As such, some employers tend to fire or demote a person due to the losses incurred.
You need to know your rights so that you can address issues that may arise when resuming your work. If you didn’t have a contract, your job security might be shaky. Your employer has the final say on your return to work after an injury.
Understanding the Workers’ Compensation Process Is Essential For All Employees
Workplace injuries are inevitable. As such, it is prudent to know the workers’ compensation process in case you get an injury at work. If your claim is justifiable, the contracted insurer should compensate you rightfully.
The compensation claim isn’t often pleasant to a company and the insurer. You might need to consult a workers’ comp claim to an attorney to help you get what you deserve. With the right information, you stand a higher chance of getting your dues.
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