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Understanding the Claims Process for Workers’ Compensation


If you’ve been injured while on the job, you may be able to file a workers’ compensation insurance claim. Once you’ve been injured, you’ll have a short period of time to file an insurance claim that will allow you to receive compensation, which is why it’s important to understand what the process entails and which steps you should take.

Reporting the Injury

The first step of the claims process occurs when the injured worker reports the injury to their employer. While reporting deadlines differ per state, you’ll typically be required to notify your employer within 30 days of the injury. There are some injuries like mesothelioma that develop over a lengthy period of time, which means that you should notify your employer immediately after you notice any symptoms.

Employer Provides Proper Paperwork

Once your employer has been notified of the injury, they are required by law to provide the employee with the proper forms pertaining to the insurance claim as well as information about the insurance benefits. The exact information that you receive depends on several factors, which include the type and extent of your injury as well as the state where the employer is based. Failure to provide the proper documentation and information to the injured worker can open up the employer to a lawsuit.

Claim Is Filed

Once you’ve filled out the insurance claim with the assistance of a lawyer, your employer will be required to submit the paperwork to the appropriate insurance carrier. The injured worker’s doctor will also need to mail any related medical reports. There are times when the employer will be required to submit certain documentation to the state’s compensation board.

Claim Is Either Approved or Denied

After the insurance carrier in question has received the insurance claim, they will take a short period of time to determine if the claim should be approved or denied. In the event that the claim is approved, you will shortly receive information pertaining to the payment and compensation that you’re set to receive. If the insurer has approved the claim, you will have the choice to accept the initial offer or negotiate for a larger settlement. Any offer that you receive should cover such expenses as medical bills, lost wages, and disability payments. If the claim is denied for any reason, you can appeal the decision or ask the insurance company to review their decision.

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