Workers' compensation claims - step by step

Workers' compensation claims

- steb by step

It is important to know the steps to follow after sustaining work-related injuries. Knowing the steps to workers' compensation claims increases individual's individual's ability to claim compensation. In case an employee is injured on the job, he or she should be compensated. Compensation is done after filing for workers' compensation claims. Most workers in USA have the right to collect compensation for their work-related injuries. The steps an employee takes after injury sometimes determine their ability to claim the compensation. Injured workers must follow the correct procedure when filing a claim.

Introduction

Workers' compensation system provides a clear procedure for claiming compensation. Actually, there are clear steps to follow. However, navigating workers' compensation claims steps can be overwhelming. This is especially true if you have no background on law. It is therefore, important to break the whole process down into simple chunks.

Step-by-step process

You have a right to receive compensation when you suffer work related injuries. Unfortunately, most workers reduce their ability to receive compensation because they don't follow the right procedure. When filing a claim, you should make sure that you follow the right procedure. Otherwise, you will be reducing your ability to be compensated. Following the right steps will help you a great deal with your case. Here are the steps to follow:

Step 1 – Report your injury

You should report any injury that occurs. When you are injured, report to the supervisor without delay (within 30 days or sooner is better). When reporting an injury, you should be very clear that the injury is related to work. You must also be very specific. When repotting an injury, make sure that your supervisor creates an official accident report. The report will be extremely helpful for your workers' compensation claims case.

Sometimes, some supervisors may refuse to prepare or create an official accident report. Some may also exclude some important details in the report. In such cases, you should document the injury in an official letter to him or her. Try to get your supervisor to sign something that acknowledges the receipt of the letter. This will be very helpful, especially to a workers' compensation lawyer that will handle the case. Be sure to get a copy of an official accident report.

It is easier if your supervisor prepares an official report. All you need to do in this case is to keep a copy. If the report is not prepared, then keep a duplicate of the letter. Also keep a note of the date you delivered the letter. Such documents are usually very helpful. Your worker's compensation lawyer will need them.

As an employee, you can report the injuries yourself. Alternatively, another employee can also report the injuries on your behalf. In fact, every employee is obligated to report any work related injuries they see. The injuries should be reported to a manager or a supervisor. Some of the injuries that you should report to your supervisors immediately include:

  • Occupational diseases
  • Cumulative-trauma injuries
  • Acute injuries

Step 2 – injury is reported to the administration level

After creating an official incident report, your manager or supervisor will report it to administration level. When I talk of administration level, I mean the higher office. It can be your employer or the owner of the company. It can also be to the human resources department or office administrator.

Step 3 – See a Doctor

After reporting the injuries, see a doctor right away. The doctor is supposed to evaluate your health as soon as possible. Your employer may send you to their preferred physician. However, under Maryland law, you have the right to choose your own doctor. You should explain your injuries very clearly to the doctor. Specifically, begin by stating that it was actually a work injury.

Depending on your injuries, the administrative staff sends you for the appropriate level treatment. You may also be sent for appropriate level evaluation to health care providers. The health care providers must be those that are approved by the state's workers' compensation program.

The doctor will give you medical instructions. Make sure you follow them precisely. For example, your doctor may recommend that you don't work. He or she may also recommend that you avoid certain activities. Follow all these instructions strictly. Failure to do so may complicate your workers' compensation process.

Request notes for any recommendations that your doctor makes. These notes may be very helpful to your workers compensation attorney. Send all medical bills to your employer or to your employer's insurance company. If you don't know where your medical bills should go, then talk to your workers' compensation lawyer. He or she will help you out.

Step 4 – Filing the forms

The administration or your employer submits a First Report of Injury form to the workers' compensation carrier. The form is submitted together with any additional form that the state requires. After which, you will be interviewed. An investigation form is usually filled out after the interview. Your supervisor then completes an official report.

Your employer will fill all the necessary forms before sending them to the workers' compensation carrier. Your employer will provide you with an official claim form. It is actually part of the workers' claims process. If your employer doesn't give you the form, then you should request one. You can always get one from your state's workers' compensation board. Typically, you will be required to provide information such as:

  1. Type of injury and the affected areas of your body
  2. Location, date, and time of injury
  3. How the accident occurred
  4. People involved in the accident
  5. The medical treatment that you have received

Step 5 – The Carrier assigns the claim a number

After your employer submits all the necessary documents, the carrier will assign the claim a number. This marks the beginning of the main compensation claims process. In case the incident is minor, then it will be marked Incident Report Only (IRO). This also means ‘medical only for the records'. However, the record is kept in the system. It actually stays there just in case something related to the injury comes up.

In case no medical bills or any other paperwork is submitted within a year, the claim is shut down. In other words, the claim is shut down if no action is taken. To avoid this, make sure the forms are submitted in time. Otherwise, you might not be compensated.

Consult an attorney

You obviously don't understand the legal process of workers' claims. After all, you are not an attorney. So, the best thing to do is to talk to your workers' compensation lawyer. Be sure to stay in contact with him or her throughout the workers' compensation process. A workers' compensation attorney will walk you through the right steps to getting a successful claim. Be sure to talk to your attorney every time an insurance company contacts you.

It is advisable that you don't discuss your case anyhow. In other words, avoid discussing your case with anybody is it at work or anywhere else. You should only discuss it with your workers' compensation lawyer. When you work with a lawyer, you will be very happy. You will be as happy as the smile should be remarkable on your face at the end of the worker's compensation process.

Employers' responsibility

According to the statute, it is the responsibility of employers to complete compensation claims process. Failure by an employer to complete all the valid claims is a criminal offense. However, as an employee, you should ensure that your employer reports your injuries accordingly. Try to make sure that every necessary document is submitted.

Conclusion

Workers' claims processes do not require much of the employee. As an employee, you complete your part of the process after filing the necessary papers. However, it's still necessary to understand all the steps. This will enable you to follow up properly on your claim. You may also want to keep some detailed records of your claim. In case your claim is rejected, you will probably the right to appeal.

ClaimFight.com - Sherlin Lindsay - author / writer

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