When you are injured at work, the idea of making a workers’ comp claim can feel a little overwhelming if you do not understand the process. Unfortunately, some employers are reluctant to share information with their employees that will help them with their workers’ comp claim. Nonetheless, you have certain legal rights after an injury, and knowing how to assert a claim is half the battle. Use this quick guide to the basics of how the worker’ comp claim procedure works.
You must notify your employer of your injury as soon as possible after the accident. Usually, you have just a few days to report your accident to your employer. Failure to meet this notice requirement can ultimately undermine your claim. In fact, you may be precluded from receiving benefits at all.
Even if you think your employer already knows about your accident, it is a good idea to share information with your boss in writing. Be sure to keep a copy of the notice that you have provided to your employer; you may need it later.
Getting Medical Treatment
One of the benefits that you receive through workers’ compensation is medical payments. In some states, the medical bills are submitted directly to your employer’s insurance company. In others, you must use a specific card to show the hospital or another medical facility that the insurance company will be covering benefits. Either way, you are generally not responsible for medical expenses after an accident if the workers’ compensation carrier has accepted your claim.
If the workers’ compensation insurance carrier is disputing a claim, you may need to pay for your medical expenses up front first. Only when you enter a settlement agreement or succeed at a hearing will the insurance company reimburse you for those expenses.
Independent Medical Examinations
In addition to your regular medical treatment, you may also be asked to go through an Independent Medical Examination (IME). This examination is done by a doctor that is not your treating physician. He or she will evaluate your injury and determine if you need additional treatment or if you have reached “maximum medical improvement” (MMI).
The medical professional will also provide an impairment rating for your injuries as well. This rating will indicate how much functional impairment you have lost due to the work injury. This rating will correspond with how much you can receive in workers’ compensation benefits. You may need to undergo an IME at your employer’s request and to present your own case as well.
Hearings and Disputed Claims
You may have to comply with the notice requirements, get medical treatment, and undergo an IME even when the workers’ comp claim insurance carrier accepts your request. However, when claims are disputed, you may also have to do some extra work to prepare your case to go to a hearing. A hearing is just like a “mini” trial, and you undergo the full discovery process to get ready for the hearing. Your attorney will be able to help you prepare and present your case at the hearing. If your claim becomes disputed, it is especially important to have a workers’ comp attorney on your side. Call our team for more information.