If you are injured while on the job, you would qualify for worker’s compensation benefits. According to the Social Security Administration (https://www.ssa.gov/policy/docs/statcomps/supplement/2013/workerscomp.html), worker’s compensation benefits would pay 100 percent of the medical bills associated with the accident. It also pays cash benefits for lost wages. If you have been injured on the job and you are planning to file for worker’s compensation benefits, there are a few things you should know.
The best way to be sure that your claim is approved is to do everything right during the claims process. The correct answers to the questions listed below determines whether your claim is approved.
Are You An Actual Employee?
To be eligible for worker’s comp benefits, you must be an employee of the company. If you are an independent contractor, a real estate broker, or a commission salesperson, you would not be eligible to receive benefits, even if you get injured on the job. Whether you are a full-time or part-time employee is not an issue. As long as you are an employee of the company, you are eligible for worker’s compensation benefits under the law.
Were You Injured On the Job?
To be eligible for benefits, you must become injured while working. If you get injured in the parking lot while walking into work, you might not be covered. If you are injured in an accident driving to or from work, this also wouldn’t be covered under worker’s comp. The same is true if you are injured in a common area during a break. If you were injured on the property but not while doing your job, your claim might not be approved.
Did You Notify Your Employer of Your Injury?
According to PayScale (https://www.payscale.com/career-news/2015/08/5-reasons-employees-get-denied-for-workers-compensation), one of the most common reasons that worker’s comp claims get denied is that the employee neglected to inform their employer of their injury. According to Worker’s Compensation law, your benefits can be denied if you neglect to inform your employer either verbally or in writing. You have 45 days to do so after an injury, and 90 days after radiation exposure.
Have You Seen a Doctor?
Immediately after a workplace injury, you should seek medical attention. Without medical documentation, your claim could be denied. All of the medical notes including the doctor’s examination, the diagnostic tests, and the resulting prognosis will all be important parts of your claim. If there is a gap in the time of your accident and the time that it took for you to receive medical treatment, there would be a dispute of whether or not you were actually injured on the job. The sooner you see a doctor after the injury, the better.
The Appeals Process
If your worker’s compensation application was denied, you have the right to appeal the decision. A few common reasons for application denials include:
- Missed deadlines
- Disputes regarding whether the injury was work-related
- Your condition doesn’t meet state guidelines such as psychological or traumatic conditions
- You filed the claim after leaving your job
If your application was denied, you can file an appeal. When your claim is denied, you will receive a letter. On the back is the process to file an appeal. You should understand that not every appeal results in an overturned decision. If you think that you need help with your appeal, you should contact a lawyer for assistance.
Worker’s compensation benefits are in place to protect employees who were injured while on the job. Your best chance of being approved the first time is to do everything correctly the first time, and get a good workers compensation lawyer.