Sustaining a work injury can be a scary situation, especially if it’s one that may have you out of work for a while. When filing a workers’ compensation claim due to a work injury, there’s a lot of “red tape” to go through — papers to fill out, deadlines to meet, doctors to see — but, keeping yourself informed about how to get started can make the situation less daunting.
If you’ve suffered an injury at work, here’s what you’ll need to know:
1. Your Accident Report is Vital to Your Claim
One of the most vital pieces of a workers’ compensation claim is the accident report. Employees should notify their employer as soon as possible that an accident on the job has happened. Next, an accident report should be prepared. The following needs to be included:
- Explanation of how the accident happened
- What parts of the body were injured
- Who the accident was reported to
- Any witnesses that were present when the accident happened
Work injury reports are also helpful to keep the details of the accidents top-of-mind should an interview be necessary.
2. Time is of the Essence
Being timely with filing can reduce your chances of a claim denial. In the state of California, a work injury must be reported within 30 days after an accident. Failing to meet this deadline could cost you workers’ compensation benefits that you would otherwise be entitled to if you filed on time.
3. Common Reasons for Claim Denials
There are many reasons why workers’ compensation claims are denied. The good news is, you have the right to appeal a denied decision. The appeals process is very complicated, so having an experienced workers’ compensation attorney in your corner can increase your chances of a claim approval. However, the first step toward a favorable decision is to understand why your claim was denied. Here are some common reasons:
- The injury was not reported in time
- Missed deadlines
- The claim was disputed by the employer
- Claimant failed to obtain medical treatment
- Insufficient evidence to support the injury happened at work
4. There Are Laws to Protect You From Employer Retaliation
All states require employers to carry workers’ compensation insurance if they employ five or more regular full-time workers. It is meant to protect both the employee and the employer. The employer is protected against personal injury lawsuits and employees are protected by receiving benefits when they cannot work due to a work injury. However, it is unlawful for employers to fire an employee for filing a workers’ compensation claim. This is considered retaliation and if you find yourself in this situation, contact a workers’ compensation lawyer immediately.
5. What is an “At Will” Employee
California is an “at will” state. This means that an employer can terminate employees for any reason or no reason at all. It also means that employees can leave their position at any time for any reason or no reason at all. While your employer may be able to terminate you for any reason, sustaining a work injury is not one of them. It is not legal and is grounds for a lawsuit against the employer for retaliatory termination.
6. Your Doctor Can Make or Break Your Case
Your attending physician is responsible for not only the treatment of your work-related injury but the paperwork and reporting that comes along with it. A doctor well-versed in workers’ compensation claims will be able to perform the following:
- Submit all reports on time and completes them correctly.
- Meet report deadlines – Missing report deadlines could jeopardize an injured worker’s case.
- Submit correct information – Incorrect or incomplete information on doctor reports could delay your workers’ compensation payments.
- Request for Authorization – Doctors must sign and submit a “Request for Authorization” before they can begin treating you. Any treatments received prior to authorization may not be covered under workers’ compensation.
7. Know the Rules of Changing Doctors in Your Case
If you are unsatisfied with your workers’ compensation doctor, you do have the right to find a new physician, however, keep in mind that your employer may have a medical provider network set up. In the state of California, you will only be able to change doctors within that network. If you are still unsatisfied with the new doctor, you may be able to request an out of network doctor. However, before you switch doctors or make any other changes in your workers’ compensation case, consult with your attorney first to ensure that any changes won’t negatively affect your case.
8. What to Do if You Are a Contracted Employee
Contracted employees can be defined as freelancers or independent contractors. While they are not technically regular employees in a company, there are still some responsibilities that the employer must uphold. The guidelines for contracted employees in a workers’ compensation case can be tricky. If you are an independent contractor and you’ve been dismissed due to a work-related injury, it’s best to contact an experienced workers’ compensation attorney for assistance. Since each case is different, a workers’ compensation attorney will be able to look at your situation to determine if the employer is liable and if you have the right to file a workers’ compensation claim.
9. Signs Your Work Environment is Unsafe
Knowing you are working in a safe environment not only helps you feel secure and confident in doing your job, but you can also be confident that you’re less likely to sustain a work-related injury. However, there are some red flags that can indicate your workplace may not be so safe after all. Here’s what to look out for:
- Overworked Employees
- Lack of safety rules
- Lack of safety equipment
- Hostile environments
10. Why It’s Crucial to Have a Work Comp Attorney on Your Side
If you decide to take on a workers’ compensation claim on your own, you’ll get overwhelmed and stressed. You’ll be expected to know filing deadlines, as well as workers’ compensation laws. Having a work-injury is painful enough and getting better should be your only concern. So why make the situation more difficult? Having an experienced worker’s compensation attorney on your side is crucial for your chances of a favorable decision.
