Before you can file a workers comp claim, most states require your first step to be to report your injury or illness to your employer. Each state has a different time limit for when you have to report a work-related incident. It is often within 30 days; however, it can be as few as 3 days or up to 1 year in some states, so if you are injured on the job, it is imperative that you report it as soon as possible.
The longer you wait, the more skeptical the insurance company may become to your claim, and let’s face it, the sooner you file, the sooner you can begin to receive your benefits. Should your injury require medical attention, you must seek treatment immediately per your state’s guidelines unless it is an emergency, in which case you can go to the nearest ER or urgent care.
Filing Your Workers Compensation Claim
Following your injury or illness report to your employer, they most likely will provide you with the necessary forms for you to move forward with your workers comp claim. Then they will typically be the ones to send into the insurance company and the state workers compensation agency. Depending on your state, this may officially be the beginning of your claim. In this situation, you only need to file with the state workers comp agency if you have been denied benefits and choose to appeal that decision; all other states will require you to file a claim form at the start of your case.
Make sure you know your specific state’s requirements at this stage; the deadline will vary. If you need further assistance filing your claim, you can contact your state’s workers compensation agency for more information, necessary forms, as well as assistance. It is highly unlikely that your employer will decline to work with you while filing your claim; however, if this is the case, call your local workers comp office as this is likely all it will take to rectify the situation.
Once your claim is filed, an investigation will be conducted by the insurance company before any approval of the claim. You should have the decision within 2-4 weeks of the investigation. In certain states, if your claim isn’t denied by the specified deadline, it is automatically deemed approved; however, this is different for every state, so stay informed as to regulations that apply to your specific area.
Once your claim is approved, you will begin receiving benefits. If your claim is denied, it is your right to appeal the decision. At this point, it may be beneficial for you to contact an attorney as this process can become quite complicated and requires you to adhere to even more strict deadlines. Most often, this won’t cost you upfront but rather take a percentage of your benefits should you win the case and charge you nothing if you lose.