If you suffer a work-related injury or illness, you probably have the right to recover workers' comp benefits such as medical costs and lost wages. But you aren't automatically entitled to benefits just because you were hurt. In order to ensure that you receive all your benefits, you'll need to file a workers' comp claim.
The first step in making a claim is reporting your injury. Each state has different reporting requirements, so you'll need to follow the laws of your state. If you don't make a report by your state's deadline, you could lose your right to workers' comp benefits.
Before you do anything else, you should get the medical care you need. Be sure to explain to your doctor how you got hurt, including the fact that your injury or illness happened at work or during a work-related activity. Insurance companies are likely to deny your claim if your initial medical records don't adequately describe the accident and injury.
As soon as you can, tell your supervisor about the injury and ask for the form to make a written report. You could lose your right to workers' comp benefits if you don't make a report within your state's required time period. Deadlines for reporting vary widely by state, but most states require you to report your injury or illness to your employer within 30 days or less of the date it occurred. In some states, the reporting period is as short as three or four days, so be sure to check with your state's workers' compensation agency to avoid missing the deadline.
If you have an occupational illness or a condition that developed gradually, such as arthritis or carpal tunnel syndrome, the time period for reporting your illness typically begins to run as soon as you discover the condition and its relationship to your work.
Regardless of how long you have to report your injury, it's a good idea to do so as soon as possible, as your employer's insurance company will likely be more skeptical of your claim the longer you wait to report it. Reporting your injury sooner also means you'll start receiving any benefits earlier.
Not all states require a written report. In some states, oral notice is allowed—typically by telling your supervisor or Human Resources department. Reporting your injury to a coworker usually isn't sufficient. But even if an oral report is allowed, a written report is a good idea. If there is any question about whether you reported your injury on time, you will have documentation to prove that you did.
Insurance companies often use accident reports to dispute workers' comp claims. For example, they might compare the information in your report to your doctor's initial treatment records. If any of the information you reported is incorrect or inconsistent, your workers' comp claim might be denied.
It's important that your report be accurate and honest. It should include any symptoms you're experiencing, even if they seem minor. Minor symptoms can sometimes develop into more serious ones. For example, suppose you hit your head at work and have only a minor headache. While it may seem trivial at the time, it could develop into something more serious later on. If the first mention of a headache happens weeks after your injury, the insurance company might question your credibility and deny your claim.
You should avoid including any diagnosis in your report if your doctor hasn't given you one. And if the cause of your injury or illness isn't obvious, you should avoid guessing about what might have caused it.
In addition to reporting your injury to your employer, most states also require you or your employer to file a claim with your state workers' comp agency. The deadline to file a claim is usually about one to three years after your injury.
A workers' comp attorney can make all the difference in recovering your workers' comp benefits. An experienced lawyer can ensure that you meet your state's reporting and filing deadlines, and can also deal with the insurance company on your behalf, prepare you for depositions and hearings, and help you with your appeal if your claim is denied, among other things.
Hiring a workers' comp lawyer usually won't cost you anything out of pocket. In most states, workers' comp attorneys don't charge a fee unless you win your case.