Employees can be seriously injured when on the job. An employee who is unable to work as a result of an injury can file for worker’s compensation. Employers obtain insurance policies for it, and if an employee is injured on the job, these policies permit the employee to receive financial relief while protecting the employer from frivolous claims.
Applying for workers’ compensation is relatively simple. Different states have different requirements for workers’ compensation, but the overall process is similar. Claimants must notify the employer, be examined for injuries, apply for workers’ compensation, and possibly dispute the decision.
Notify the Employer
The very first step in a workers’ compensation claim is to notify the employer of the injury. The injury must be reported in a timely manner; failing to report the injury beyond a statutory threshold may result in the claim being denied. The employer will furnish workers’ compensation forms to the employee or information on how to submit a claim. Notice requirements differ between states.
In New York, for example, one must demonstrate that they are “free from control and direction in performing the job,” and if you’re unable to convince the State of this, be sure to contact someone in family law, or one of the best lawyers in NYC. If an employer does not provide detailed information regarding a workers’ compensation claim, injured employees should contact the state regulatory agency responsible for workers’ compensation claims within that state.
If the employer fails to provide the employee with these forms, the employee may initiate the process manually. This can include contacting the employer’s insurance provider or the state regulatory agency.
Consult a Physician
Determining the exact scope of the injury is critical to a workers’ compensation claim. When an injury occurs at work, employees should take preventative steps to ensure that the injury does not become aggravated or lead to more serious consequences. At the doctor’s office, urgent care clinic, or emergency room, injured employees will be reviewed by their personal physicians. The doctors will assess the injury and treat the patient. After this visit, the employee should understand the scope of the injury.
Obtain and Submit Forms
The next step in applying for workers’ compensation is to submit the necessary forms. State laws differ on how the submission process works. In California, workers retrieve a form from their employers or from the state agency, fill in the section for employees, and turn the remainder of the form over to the employer. The employer will then turn it over to his insurer, which will assess the claim. In Texas, the injured worker will apply directly to the state’s Department of Insurance, Division of Workers’ Compensation.
Each state requires different forms and information from claimants. The forms and information regarding the claims process for a specific state is available from the regulatory agency in that state. Claimants must fill out all forms and properly submit them for the claim to proceed.
Dispute the Decision if Necessary
Not all valid claims will be approved. If a claim is denied or delayed, claimants can usually appeal the decision with the help of an injury or family attorney. In most states, this entails filling out another form and submitting it to the state regulatory agency.
This form will permit the claimant to receive a medical evaluation from an impartial physician. An attorney representing a claimant may work with the claims administrator to determine which doctor will evaluate the claimant. This physician will assess the patient and determine the validity of the claim.
Applying for workers’ compensation can be difficult. State regulatory agencies exist to assist workers with the process, but can only do so much. Uncooperative employers and insurers can delay the process and make it difficult for injured employees to receive workers’ compensation.
If an employer or insurer is delaying the process, or if the claim is denied, the claimant should retain legal counsel. An attorney can help the claimant through the process and ensure that he or she completes all necessary filings within their respective deadlines.
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This is a guest post. Saam Banai is a freelance writer and editor. He contributes this article for The Perecman Firm, a team of some of the best lawyers in NYC. The firm specializes in personal injury cases, workers’ compensation claims, and cases involving construction accidents. With over 30 years of experience, David Perceman will handle your case with compassion and expertise.