Whether you’re an employer or an employee, it’s important that you know about the worker’s comp claim process.
This multi-step process begins when an employee suffers a work-related injury or illness. Following these injuries, employers have a limited amount of time to report them to create a claim.
When a claim is not filed within the specified amount of time, it can lead to the worker’s compensation insurance being denied. This can leave both the employer and employee at a loss. This is why it’s so important that you are aware of the process.
If you’re an employee, it’s your responsibility to alert your manager that you have been in an incident at work. You should have been informed of the correct accident reporting process by your employer when you were hired.
If you’re an employer, it’s your responsibility to submit this report and create a claim. It’s vital that you report the injury or illness as soon as it has occurred. This enables you to gain workers’ compensation insurance.
It’s important that you follow the right steps when you’re filing a worker’s comp claim. Failure to do so could result in your claim being denied, even if you create the claim within the specified time limit.
So, what are the key steps of the worker’s comp claim process?
Gathering Details About the Incident
The first step of any claim is gathering the details of what has happened. Once the affected employee has been treated for their injuries or illness, you will need to have an in-depth conversation with them to document as much detail of the event as possible.
Whether they’ve suffered from a broken bone or chronic neck pain, gathering the necessary details is key to winning your claim. You should document everything, as this information will be required when you submit the claim to your insurers.
Give your employee the necessary paperwork to fill in the details of their incident, including the date, time, location, and circumstances of the incident. The exact form is that your employee will need to fill out depends on which state you and your employee are based in, the type of injury, and your insurance company.
Sending the Claim
Once you have gathered all of the necessary details from your employee, it’s your responsibility as the employer to send the claim form to the workers’ comp insurers. If a medical form is required, your employee’s doctor will need to provide this.
Approval or Denial of the Claim
Once the claim has been filed, the insurer will assess the claim and either approve or deny it.
If the claim is approved, the insurer will contact the employee and send them the details of their compensation. If the employee has hired a workers’ compensation lawyer, the lawyer will either accept or dispute the compensation amount that has been offered.
In the event of a claim denial, you can either request a reconsideration or file a formal appeal that will go through the state workers’ comp board.
Workers’ compensation laws can vary from state to state, so make sure that you check your state’s specific regulations and deadlines so you are compliant.