File Your Workmans Comp Claim Right the First Time

Workmans compensation claim procedures...

• Notify your employer immediately of any work-related injury or illness you sustain. Delays in reporting your injury and submitting claim information and forms can jeopardize your workmans compensation benefits. Some states have very strict provisions in this regard. South Dakota, for example, requires employees to notify their employees of an injury or illness within three days.

• If necessary, seek medical attention immediately. Employers are required to cover an injured employee's immediate medical needs. Medical bills should be forwarded to the employer's personnel office. If compensible via workmans comp, they are not to be billed to the employee's health insurance carrier.

• Request and fill out all necessary workmans compensation claims forms, provided and filed by your employer. Examples include the "First Report of Injury," "Initial Medical Report Form," and "Accident Report Form." In some states, an initial medical report is expected the day of injury or illness.

• Ask your employer if you can select your own physician for evaluation or if it has the right by law to assign you a medical examiner for your claim. The medical examiner's report will be used to determine your workmans compensation benefits.

• Obtain written confirmation from your assigned doctor for any authorization to miss work. Request copies of any forms or authorizations your doctor sends your employer's workmans comp insurer.

• Insurers and third-party administrators generally have 10 to 14 days to investigate and respond to workmans comp claims. They also typically must send a "Notice of Claim Received" to employees. A "Notice of Compensation Payments" or "Notice of Dispute" usually follows, stating in writing that your claim has been accepted or denied. If your workmans compensation claim is accepted, disability payments are retroactive, covering days between your injury and your claim's approval.

• Most states require insurers to pay employee expenses, incurred in the course or treatment or vocation and physical rehabilitation. Keep all receipts and record your mileage for reimbursement.

• Throughout the workmans compensation claims process, expect your employee to monitor your progress and to make accommodations for your return. In the interests of controlling workmans comp costs, many workmans compensation laws feature early-return-to-work provisions.

• Work-related injuries and illnesses are subject to a statute of limitations. Usually, claims cannot be filed after two years.

Workmans compensation claim procedures...

• If the processing of your claim is delayed, hire a workmans comp attorney to protect your rights. In most states, attorneys only collect if your workmans compensation claims are accepted.

• If your claim is denied, contact your assigned claims adjuster and inquire why. If you feel you have been treated unfairly, hire a workmans comp attorney or contact your state workmans comp agency to discuss your options, such as filing a "rejected claims appeal" or "petition for review."