What Is The Filing Process?
The first step in the filing process for a typical workers' compensation claim is to file an employee claim form report of the incident. This should be filed as soon as the injury occurs. Your employer will then file the report with the private insurer that provides coverage for your company. Depending on your state of residence or employment, the form varies. Each state has a specific form and process. Furthermore, some state workers' compensation boards require that the form be filed directly with the board.
Either the review board or the insurance company will review your initial claim. You will typically be asked to undergo an independent medical examination (IME) with a doctor that is chosen by the insurance company. The results of this exam are given to the insurance company, and are used to determine its compensation offer.
Should the claim be approved, your benefit payments will begin shortly after you receive notice of approval. However, initial claims often require further supporting evidence (such as a second medical examination from another doctor), or are denied.
Insurance companies sometimes refer to a denied claim as a "controverted" claim. Should your initial claim result in this status, the next step is appeal. You are also able to appeal the compensation decision if you are unhappy with the results and do not feel you are being adequately compensated for the injury, or not receiving authorization to visit needed medical specialists.
The appeal process can be frustrating and time consuming. Each state has a specific process of appeal, yet regardless of the state, the process is best handled with the assistance of a legal professional. Insurance companies have experts that handle disputed claims and they have considerable experience in the workers' compensation process. You are entitled to represent yourself, however, as with any legal proceeding, a legal professional will ensure that you receive the maximum amount of benefit for your disability.
Do I Need An Attorney or Lawyer?
Filing a claim for Workers’ Compensation can be complicated and frustrating. Your employer’s insurance carrier may try to deny your benefits with many different tactics, such as asserting that you were not injured at work, that your condition does not warrant compensation, or that it was a pre-existing condition.If you believe you have been unjustly denied, an experienced Workers’ Compensation lawyer legal representative can provide the legal help and guidance you need.
Employees have many rights in the workplace which are mandated by both state and federal laws. These include the right to Workers’ Compensation, to be free of discrimination by employers, and rights under wage and hour laws.
Accidents can occur in any type of workplace, from an office to a warehouse to a construction site to a traffic accident while driving a company vehicle in the performance of one’s duties. When you are injured while on the job, you are generally protected by your state’s Workers’
What Are Workers Compensation Benefits?
Those who are injured at work or while performing work duties or who develop occupational diseases stemming from their work environment are protected by Workers’ Compensation laws. Each state has laws which provide medical care and wage replacement benefits to workers in exchange for workers relinquishing their right to bring a lawsuit for negligence against the employer. Negligence is generally not an issue in these cases unless negligence by a third party unrelated to the employer contributed to the accident or injury. Each state, however, has its own rules and guidelines regarding Workers’ Compensation claims and disputes. Most Workers’ Compensation insurance is provided by private insurance carriers that will process a claim and provide benefits under state laws.