To initiate the workers' compensation process, an injured employee must file a workers' comp with the employer's insurer within the stipulated period. However, depending on the outcome of the claim investigation, the insurer may accept or reject the claim. In fact, workers' comp insurance companies reject about 7% of workers' comp claims every year for reasons such as ineligibility and untruthful reports. To win your workers' compensation claim, follow these seven steps.
Before you file a workers' comp claim, ensure you meet all the requirements for filing a workers' compensation claim. In general, you need to be a full-term or part-term employee who has suffered a work-related illness or injury. Independent contractors and freelancers are not automatically eligible for this coverage, but they can be eligible under certain circumstances.
Insurance companies only process claims filed within the specified timeframe. The deadlines vary by state and insurer and may last from a few days to a few weeks. Keeping this in mind, ensure you file the claim before the stipulated deadline. One tip to avoid missing the deadline is to file the claim as soon as the injury occurs. For gradual injuries or illnesses caused by repetitive exposure to work-related hazards, you should consult an expert to help you determine the exact date of the injury, and hence, the deadline for filing a claim.
You should notify your employer or immediate supervisor about your work-related injury or illness. You should do this immediately after the injury/illness to prevent further injuries and enable the employer to file a report that can be used to investigate the incident. Take note that you have a limited period to inform your employer about your injury/illness. This period varies from state to state.
Upon learning about your injury, your employer will require you to seek treatment from designated physicians. In general, you have to see a physician chosen by your employer within the first 90 days of your injury/illness. You can get treated by your private doctor, but if your doctor and your employer's doctor disagree on the nature of your injury, your claim will be denied.
Your employer's insurer will look for any excuse to reject your claim. Therefore, you need to research widely and have the right information at hand, including your legal rights and the claim appeal process. One way to learn about workers' comp is to talk to an experienced workers' comp lawyer.
After filing your claim, you should not just sit and wait for the outcome. Instead, you should follow up and push for your benefits. Remember, waiting doesn't do much other than increase the chances of claim denial. Therefore, constantly follow up with your employer until you receive your benefits.
Only about 5% of workers' compensation cases go to trial. However, if your claim is denied or you receive inadequate benefits, you should not be afraid to make an appeal. Take note that filing a workers' comp appeal can be a challenging and complicated process. Therefore, you should hire an experienced attorney to help you navigate the process.
Contact our experts at Kneller Insurance Agency today if you have any questions about protecting your business and employees with the right insurance coverage. We can help you address your insurance coverage needs.
