Workers’ compensation cases are unlike any other type of legal claim, but the process of settling workers’ comp claims is quite similar from state to state. There are slight variations but the general idea is the same, and one thing that never changes is that the process of filing and settling a workers’ compensation claim is a long and complicated one. Having an experienced workers’ comp lawyer (like Laurie Robbins) on your side during the lengthy complex process will allow you to have a guide on this difficult journey—someone to explain what you must do, what will happen next, and what you can expect at the end of the process.
Many initial workers’ comp claims are denied. What happens after a claim is denied depends on you and your attorney. If you decide to appeal the denial, you will need an attorney to navigate the appeals process. Even before any appeal is filed, the workers’ compensation claim process is a long and complex, and it all starts from the moment you’re injured on the job.
When you’re injured on the job, there is a small window of time to get the paperwork filed for both the injured worker and the employer. When an injury happens on the job, the employer must:
- Give the employee the appropriate paperwork and instructions
- File the workers’ compensation claim with the employer’s insurer
- Comply with state law for reporting work injuries
And the injured worker must:
- Notify the employer of the injury (date, time, type of injury, and how it occurred)
- File a formal workers’ compensation claim using the paperwork provided by the employer
- Contact a workers’ compensation lawyer (people have tried to file workers’ comp claims without the assistance of an experienced lawyer, but this is not always the best course of action)
In order to file a workers’ compensation claim, the following must apply:
- The employer has a workers’ compensation policy
- The injured worker is an employee of the business (not an outside or independent contractor)
- The employee was injured while at work
In most states, the injured employee must provide written notice of the workplace injury to the employer within a certain time frame, usually thirty days. It’s highly recommended to let your employer know about the injury immediately and to never hold off for one day let alone thirty. The longer you wait, the more likely your claim is to be denied.
After reporting the injury, your employer will provide you:
- Forms for the workers’ comp insurance provider
- A form for the state workers’ comp board
- Information about employee’s rights and workers’ comp benefits
- Information about returning to work
Ideally, these forms should be provided before the injured worker seeks medical treatment.
The employer then files a claim, and once the claim is filed, the insurer will make a determination. If the employee’s workers’ comp claim is approved, the insurer (workers’ compensation provider) will contact the employee for payment information. If the insurer doesn’t think the claim qualifies for workers’ compensation benefits, the injured worker’s claim will be denied. If the insurer approves the claim, the injured worker can accept the payment offer or negotiate for a larger settlement. Attorney Laurie Robbins understands how to get you the money you deserve to cover medical bills, lost wages, and other expenses related to your workplace injury.
If the workers’ compensation provider denies the claim, the employee can request the decision be reviewed, and the employee can appeal. A workers’ compensation appeal begins another process that’s common to these types of cases—the appeals process.
An injured employee must notify both the employer and insurance company via written notice when he has sufficiently recovered and wants to return to work. In some cases of severe injury, the injured worker will continue to receive disability payments if returning to work is not an option.
If no settlement is agreed upon, a judge will schedule a formal hearing and issue a decision in your case. A formal workers’ comp hearing is typically your opportunity for you and your lawyer to present your case in front of a judge and show why you’re entitled to benefits.