how does workmans comp work

How Does Workmans Comp Actually Work?

Suppose you’re required to move a stack of heavy boxes at work. Halfway through lifting one, your supervisor throws a bow and arrow at you. He doesn’t really, but the ache in your neck and shoulder makes you believe he did. 

What happens next? Sure, you will need medical assistance regardless of whether it’s a torn muscle or temporary pain. And this is where you’re about to enter the workers compensation maze.

Steps to Filing a Worker’s Comp Claim

Injured workers and employers alike have distinct challenges in the process of claiming workers’ compensation benefits, but it doesn’t have to be overwhelming. 

Workers’ compensation claims can be complicated, but the five steps mentioned below make the process easier for both the employee and their employer:

Notify Your Employer

Injured employees usually have to notify their employer in writing within the state-mandated timeframes. For example, if an employee is injured in California or New York, they must notify their employer within 30 days. In contrast, other jurisdictions allow employees up to a year to notify their employer. For example, in Chicago, you can even claim 2 years after the last time you got disability benefits or had a medical bill paid on your behalf and three years from the date of your injury.

Injuries such as a broken arm caused by slipping on wet office floors or carpal tunnel syndrome from keyboard overuse may qualify for compensation. However, non-emergency care must be obtained from a medical practitioner in the insurer’s network to be eligible for benefits.

Fill Out the Necessary Documents

In most states, you’ll be required to complete a workers’ compensation claim form by your employer’s human resources department. Your injuries will be described in detail here, along with the circumstances surrounding their occurrence. HR can help you understand your employer’s rights and workers’ compensation benefits once you’ve notified them of your accident. 

Organizations include workers’ comp insurance information in their new hire employment packet to assure their employees know their rights if they’re injured on the job. If your employer fails to share this information, you can file a lawsuit against them. 

In general, the following information will be required on your workers’ compensation claim form:

  • The nature of the injury and the injured body parts.
  • Injury details such as the date, time, and place.
  • The individuals or entities who were involved in the accident.
  • What caused the accident.
  • Former medical treatments (if any).

Report the Injury

The claim form and its accompanying papers are often sent to the employer’s workers’ compensation insurance carrier. Depending on the state where you live, your employer may also need to notify the division or board in charge about the injury. Even if you aren’t seeking workers’ compensation payments—it is still mandatory. 

Check if the Claim is Approved or Denied

After reporting the claim, it will be either approved or denied. The insurer is responsible for notifying both employer and employee about the final decision. If approved, accept the payment offer of the insurance company, which covers the costs of medical bills, portion of lost wages, and disability payments. You may also negotiate for a higher settlement. If denied, you should request a reconsideration from the insurance company and submit a legal request, which is usually handled through the state workers’ compensation board.

Return to Work After Recovery

Once you’ve recovered from the injury and are ready to return to work, you must notify both your employer and insurance company in writing. The insurance company may have to give permanent disability payments depending on the severity of the damage. 

Many organizations widely use Return-to-work programs to help their employees return to work as early as possible. Some organizations even grant modified duties or specialized training to the injured workers if they cannot handle their former responsibilities.

Signs You Should Hire a Workers’ Compensation Lawyer 

If you experience an accident on the job that prevents you from returning to work for an extended period, you may be eligible for workers’ compensation. Unfortunately, things don’t always go as smoothly as they should in some situations. The complexity of workers’ compensation lawsuits, trials, and reviews necessitates hiring a workers’ compensation lawyer. Here are some signs that you should consult with a workers’ compensation attorney.

  • Your employer retaliates against you for bringing a lawsuit against them.
  • Your settlement offer covers only a portion of your medical expenses.
  • You are having trouble with your employer.
  • Your benefits have been postponed.

What Will an Attorney Do For You?

The best way to ensure that you get the compensation you’re entitled to is to hire a workers’ compensation lawyer. Workers’ compensation lawyers can help you deal with the insurance company, acquire medical proof to back up your claim, negotiate a fair payout, and represent you in court if you have to go through the hearing process. 

No one at the insurance company is looking out for your interests. They will not hesitate to deny your legitimate claim for vague reasons. Fortunately, a workers’ compensation lawyer has the knowledge and experience to win your case.

The Final Cut

Injured workers across the United States file workers’ compensation claims in each state every year. Now that you probably know what workers’ compensation is and how it may help you recover the lost pay, use it to your maximum advantage. To ensure that you receive the compensation you deserve, hire a reliable lawyer.

Hire WIN Injury Network to Win Your Case

If you’re reading this, you may be unsure about what to do next after getting injured at work. Contact Win Injury Network to speak with a certified and trained worker’s compensation expert. The fact that our lawyers know what it takes to achieve a fair settlement is one of the reasons why many injured workers turn to us. We have a client-centered approach and pricing structure that allows you to get legal help without incurring additional fees.