Getting injured at work can be difficult and stressful. Many employees may not have access to a paycheck while they recover and have to forgo a proper recovery to go back to work to support themselves and their families. A workers’ compensation program can help many workers who have experienced an accident at work relax and recover without extensive financial stress.
What is Workers’ Compensation?
Workers’ compensation, more commonly referred to as workers comp, is a type of insurance that covers an employee should they become ill or injured during their job. If an employee becomes unable to work during their recovery, workers’ comp can continue to pay them their regular wages until they can return to work. Although workers’ compensation seems like an optimal response to an unfortunate workplace injury, those who utilize workers comp after their illness or injury relinquish the right to sue their employer for any negligence that may have caused the issue.
Most workplace accidents can qualify for worker’s compensation. If a work activity, work materials, or work equipment causes an accident or illness, a person is eligible to claim workers comp. However, many accidents are disqualified for workers’ comp. Some of them include:
- Psychiatric disorders
- Injuries caused by horseplay or messing around
- Self-inflicted injuries
- Injuries caused while committing a crime
- Injuries caused by violating company policies
- Injuries caused by an employee who is under the influence of alcohol or drugs
Workers’ compensation can only be claimed if the injury or illness is caused by a true accident. If the employee was under the influence or acting in a way that would promote harm to themselves, they are not qualified to benefit from workers’ compensation benefits.
How to File a Claim
Many employees may not know what to do after their accident and how to proceed with their employer. If you have sustained an injury and are looking to claim your workers’ compensation benefits, there are a few actions that you must take.
- Notify your employer- After the accident, it is important to notify your employer immediately. By doing this as soon as possible, your injuries can be addressed quickly, preventing injuries from developing over time. This can also ensure a quicker return to work once you are fully healed. Depending on the company or organization you work for, you only have a set amount of time to report your injuries before being excluded from workers’ comp benefits.
- File a claim- After informing your employer about your accident, they will give you a series of forms to fill out for the insurance company. Depending on which state you live in, more forms may need to be filled out within a state-specific time frame. Additionally, federal employees may have a different workers’ compensation system when compared to workers who operate in private companies and businesses.
Each state has a specific statute of limitations or an amount of time where a claim must be filed before it is ineligible for legal action. This is why it is important to file a claim as early as possible or understand your state’s statute of limitations and operate within that time frame. If you miss this deadline, you may be ineligible to file a claim for this incident in the future.
The investigation behind your claim can take anywhere from 2-4 weeks for the insurance provider to complete. The claim investigator will review any of your medical reports, accident reports, and any other relevant documentation during this time. In some areas, if you do not hear a final response by the end of the four weeks, your claim is automatically approved. If your claim has been denied by the end of the four weeks, you may be able to appeal the decision or contact an attorney to assist with your claim.
When to Contact an Attorney
After you file your claim, the insurance company will view the claim and take time to make their final decision regarding it. If the insurance provider has denied your claim after the four-week window and you feel as though your case is valid enough to yield compensation, you have the option of hiring an attorney to handle your claim.
It may also want to contact an attorney if you do not hear back about your claim or if you believe that the insurance company is surveilling you. It isn’t as common as some may think; that being said, surveillance of injury victims isn’t unheard of. On these occasions, insurance companies will attempt to negate any injury claim by secretly following a victim around to gather evidence that disproves their claim.
Contact a Workers’ Compensation Attorney
If your claim isn’t being taken seriously and you would like justice, and adequate compensation for your injury, contacting a workers’ compensation attorney may be in your best interest. A workers’ compensation attorney is a type of personal injury lawyer that focuses specifically on workplace injuries. Getting an attorney to assist with your case can show your employer and insurance company that you are serious about the situation.
In many instances, a settlement will be reached outside of court to spare both parties a lengthy and pricey lawsuit. However, on some occasions, these lawsuits go to court. When you hire an attorney, you give yourself the best chance to reach a fair settlement or the best chance at winning your case.
When discussing a settlement or fighting for your case in court, your workers’ comp lawyer will advocate for an amount that covers the following expenses:
- Past, present, and future medical bills
- Any financial losses, including lost wages
- Pain and suffering
The goal of your attorney during the legal process is to prove negligence on behalf of your employer. A skilled attorney will advocate on your behalf and try their hardest to provide you with enough financial compensation to accommodate your injury.
If you would like assistance with your workers’ compensation claim and are looking for a skilled personal injury attorney, contact the Eichholz Law Firm.