Business,  Legal

Understanding the Workers’ Compensation Claims Process

Were you injured at work? Your employer will have posted notices about your rights and responsibilities regarding claiming workers’ compensation benefits somewhere conspicuous in the workplace. If you have further questions, this article will give you a step-by-step guide to claiming workers’ compensation benefits from the perspective of a South Jersey workers’ compensation attorney.

What is Workers’ Compensation?

Workers’ compensation is money paid to employees who are injured on the job by their employers’ insurance company. Every state has a workers’ compensation statute that requires employers to carry insurance and provides for a compensation schedule based on salary, how much work was lost, and the severity of the injury.

The purpose of workers’ compensation is to quickly get the worker the medical attention they need, compensate them for the time they were out of work due to the injury, and help them recover and get back to work.

Who Can Receive Workers’ Compensation?

Employees are eligible for workers’ compensation benefits. Independent contractors, subcontractors, and vendors are not. Your state’s workers’ compensation statute will define who is an “employee” for the purposes of receiving benefits.  Another valuable resource is workers compensation attorney schaumburg who can also assist you.

In most states, some 1099 workers can be considered “employees” and eligible for workers’ compensation, depending upon a number of factors related to the nature of their employment including the degree of control their employer has over their work.

What Injuries are Compensable Under Workers’ Compensation?

Any injury, condition, or disease contracted while working is compensable under workers’ compensation if the injury keeps the worker from working for at least seven days.

Injuries at the Workplace

Acute injuries such as cuts, burns, head trauma, and sprained or broken bones from slips and falls, falling debris, and machinery misuse or malfunction are among the most common causes of injury to workers and are compensable under workers’ compensation.

Diseases at the Workplace

Exposure to toxic substances such as mercury, asbestos, and lead can lead to cancer and other diseases. This is compensable under workers’ compensation.

Occupational Illnesses

Repetitive stress or strain illnesses such as carpal tunnel syndrome can develop from performing work-related duties. It is likely that COVID-19 if contracted at work, will be treated as an occupational illness and will be compensable under workers’ compensation.

How Do I Get Workers’ Compensation Benefits?

Get the Medical Attention You Need

Do not shrug off a workplace injury. Many injuries do not seem serious at first because your body is flooded with adrenaline, keeping the pain and swelling or bruising down. If you were injured at work and did not visit a doctor right away, but you notice your injury feeling or looking worse, seek medical attention as soon as you can.

Inform Your Employer

Tell your employer, a manager, or your supervisor that you were injured while working. You may do so verbally, but follow up in writing. You will be given a pamphlet explaining the process and directing you to medical providers. You will also be given a workers’ compensation claim form.

Every state and insurer has different forms, but generally, to claim workers’ compensation benefits you will need to provide the following information:

  • What kind of injury you suffered and what parts of the body are affected;
  • The date, time, and location of the accident causing the injury;
  • The names of any other parties involved in the accident, or witnessing the accident;
  • How the accident occurred, and;
  • Details of any medical treatment you have received.

Keep Track of Documents

Your medical provider will give you paperwork related to your condition and what treatment you require. You may be referred for surgery or physical or occupational therapy. Keep all of this information in a folder.

You will also be sent documents by your employer and the insurer. Be sure to retain all of those as well.

You may want to keep a daily journal of how the injury affects your ability to complete routine, everyday tasks, and your pain levels. If you are verbally told anything by a manager or your employer related to your injury or your workers’ compensation claim, be sure to document that in your journal for future reference should there be a problem with your claim.

Complete and Submit all Required Paperwork

Be sure to complete and return the claim form and all other paperwork given to you or sent to you by your employer’s insurance company. Keep copies of all documents for your records.

What to Do if Your Workers’ Compensation Claim is Denied

You should begin to receive workers’ compensation benefits within two or three weeks of filing your claim. If you do not, or your claim is denied, contact a workers’ compensation attorney in your state for help. At that point, you can take your employer to workers’ compensation court or an appeals board and a judge will decide whether you are entitled to benefits, and how much.

If your injury is severe, you may be eligible for temporary or permanent partial or total disability benefits through workers’ compensation. If the injury keeps you from working at all, you may have a Social Security Disability claim as well. Talk with your attorney.

About the Author

Veronica Baxter is a blogger and legal assistant living and working in the great city of Philadelphia, she frequently works with the Norristown car accident attorneys and workers’ compensation attorneys at The Law Offices of Craig A. Altman.



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