Steps To Filing A Worker’s Compensation Claim As An Employer
Majority of the states require employers to provide insurance coverage for their employees.
All employers should keep records of workplace injuries and assist the injured employee in filing a worker’s compensation claim. He is also required to report to the concerned authorities and submit written notices wherever it is necessary.
Given below are steps to file a worker’s compensation claim.
Notifying The Employer Of The Accident
The injured employee must report the workplace injury or accident to the employer as soon as possible. Different states have different deadlines for reporting the accident and this can vary from 30 days to 1 or 2 years. However no employee should wait this long since it will drastically reduce his worker’s compensation benefits.
If there were eyewitnesses at the scene, the employer must speak to them to get individual accounts of the accident and take photos of the location. He should also keep a detailed and written record of the accident.
If the employee has suffered serious injuries which require hospitalization, the employer must report to the OSHA (Occupational Safety And Health Administration) within 24 hours. He should also make sure the employee gets to a hospital emergency room immediately.
In less serious cases, the employer must provide the employee with a list of doctors which is approved by the company board. Some states require the employer to provide a list while some state laws might allow the employee to consult a separate doctor subject to certain restrictions.
If the employer tries to get the employee to consult a specific doctor in order to take advantage of the situation, strict action will be taken against him. If the employee suspects this, he is highly recommended to consult a worker’s compensation lawyer who will be aware of all the state laws regarding medical treatment of the employee.
If you are an injured employee who resides in Scranton, we advise you to work with an experienced Scranton workers compensation lawyer.
The Employer Will Provide Workers’ Compensation Forms And Other Necessary Information To The Employee
The employer must provide the employee with the necessary forms required to file a worker’s compensation claim and any other relevant paperwork which is to be filled.
The state worker’s compensation board will specify which forms are to be filled. Some states may require more forms to be filled than others.
The employer should also provide other information like,
- Types of worker’s compensation benefits covered by insurance along with information about employee rights.
- Whether the employee can return to work under a modified work program which will not affect his injuries. If the employee is unable to work, the employer must provide him with a written notice.
Responding To The Settlement Offer
Once the worker’s compensation claim is filed, the insurance company will review it along with all the evidence and medical records.
If the claim is approved, the company will decide on a settlement offer which will cover the employee’s medical expenses, lost wages and any other necessary payments he is entitled to receive.
In this situation, the employee can either,
- Accept the settlement amount. In this case the bills will go to the employer.
- Negotiate for a larger settlement. This happens in cases where the employee feels like he isn’t receiving the full payment he is entitled to. He might take the help of a worker’s compensation lawyer to back him up.
Denial Of The Claim
In case the insurance company denies the claim, the employee can either ask the company to review the decision or appeal to the state worker’s compensation board.
The claim can be denied either for invalid or valid reasons. Some valid reasons include,
- Missed deadlines
- Incorrect information
- Lack of evidence like medical records or a detailed accident report.
In case of invalid reasons, the employee should consult a lawyer who will tell him what his next step should be.
An employer should never discriminate or threaten to fire the employee for filing a worker’s compensation claim. If any employer tries to break state laws regarding worker’s compensation or commits fraud, he will receive high fines and penalties.