How to File a Workers’ Compensation Claim

The worker’s compensation system was designed to expedite the handling of claims regarding employee injury or illness by removing issues of employer liability from the equation.

The employer pays into what is essentially an insurance fund and employees are covered for medical care, lost wages, vocational rehabilitation services and death benefits to the dependents where applicable. If you have sustained an employment related injury or illness, it is important to follow the proper procedures to avail yourself of the covered benefits.

Notify Your Markham Employer

A worker’s comp claim begins when a report of injury or illness is made. In many situations, there is an obvious injury and the worker is immediately provided medical treatment either on site or at a medical facility. If this happens to you, in all likelihood your employer opened a worker’s comp file on you, but it is a good idea to verify that fact.

It’s different if you sustain an injury only you are aware of. As each state has established laws regarding the time frame in which an injured employee must notify the employer, there is a possibility you could lose your right to receive benefits if you delay reporting your injury.

Unfortunately, this occurs at times because workers are reluctant to acknowledge they are hurt, perhaps believing there will be negative consequences. This can be a mistake. The best procedure is to report your injury as soon as practical.

One circumstance where a delayed claim may nonetheless be honored occurs where a worker sustains an injury or illness due to long exposure to a toxin or from a repetitive motion, such as carpal tunnel syndrome, for example. In these cases, the employee can notify the employer of the injury when the worker actually learns of it or should have known of it.

Complete All the Paperwork

Sometimes the forms can be tedious, but they must all be completed and submitted in a timely manner. Most often, the employer provides the worker with all appropriate forms, but, remember, it is ultimately your responsibility as the injured worker to ensure everything is correctly completed.

If you are having difficulty with your employer in receiving the appropriate forms, you can get what you need from your state’s worker’s compensation website.

Investigation of the Claim

The claims administrator for the worker’s comp carrier will investigate your claim, which will typically involve contacting you. Your employer will have an opportunity to be heard on any matters it deems relevant to the claim, and a decision should be provided to you within a few weeks.

If approved you immediately begin receiving benefits, and you should follow all medical treatment guidelines and work diligently to recover. If you are denied, you have the legal right to appeal.

Appealing a Denial

There are many possible reasons why a claim is initially denied, but the specific reason why must be explained to you. Although in some cases a denial is simply a matter of incomplete information, more often it involves a technical reason that is difficult for a lay person to understand and argue against. It’s almost always a good idea to consult with a Markham lawyer if your worker’s comp claim is denied.

Absence of Witnesses

Witnesses may not be present during every work injury, and they’re not always necessary regardless, but it can help to name any witnesses who witnessed the accident. This helps back up any of your claims and can confirm the legitimacy of your workplace injury or illness in most work injury cases.