Employees file workers’ compensation claims to receive benefits after experiencing a work-related injury or illness. But filing a claim can be confusing, especially without the proper guidance and knowledge.
Furthermore, there are important factors and specific steps to consider for employers and employees, along with deadlines to keep in mind. In this article, we explain exactly how filing workers’ compensation claims works.
What is workers’ compensation?
Workers’ compensation is an insurance policy created to protect employers and their employees. If an employee gets injured while performing their duties, they may be entitled to receive monetary compensation to help cover medical costs, lost wages, and more.
Workers’ comp also helps businesses avoid having to cover these expenses out of pocket. And if the employee takes legal action, the insurance policy may also cover court fees. Whether you’re an employee or a business owner, it is advisable to avail yourself of this insurance policy to protect yourself against unforeseen circumstances.
What are the benefits of workers’ compensation?
Workers’ comp offers many benefits to employees, including:
- Pays for lost work time caused by work-related injuries
- Covers the cost of rehabilitation required after a serious injury
- Covers funeral expenses if they pass away
- Provides disability benefits if the employee is partially or fully disabled due to a work-related injury
Take note that workers’ compensation benefits do not apply to employees under the following circumstances:
- They are hurt or injured outside of work
- They were intoxicated during the incident
- They hurt themselves intentionally
Workers’ comp also benefits employers in the following ways:
- Pays for employees’ medical costs and lost wages if they experience work-related injuries or illnesses
- Protects the business from being sued by employees involved in workplace accidents
- Ensures the business’ compliance with laws on workers’ compensation
How the workers’ compensation claims process works
When an employee suffers a work-related accident, there are specific steps to follow for the claim to be approved. Keep in mind that filing a claim must be done as soon as possible because there’s a limited amount of time allotted for reporting the injury. Wait too long to file the claim, and it can be denied.
As the employer, it’s your responsibility to instruct your employees to report any injuries immediately. However, it is your duty as the employer to submit the claim to the workers’ compensation insurer.
When an employee of yours is injured on the job, you need to ensure that they get medical treatment immediately if they haven’t already. As soon as they are able, you will have to provide them with all the documents necessary to file a claim. You may also need to interview witnesses to the event, if there are any, and include their statements to support the claim.
After you’ve performed these steps, you can submit the completed forms and documents to the insurer. If necessary, you may have to submit an injury report to the workers’ compensation board of your state. The insurer will then decide whether to approve or deny the claim.
If the claim is approved, the insurer will contact the employee about payment details. If the claim is denied, the claimant may request reconsideration from the insurance carrier or file a formal appeal.
Steps for workers’ compensation claims
Here are the steps you need to follow when filing a workers’ compensation claim:
- Request the injury report from your employee
- Guide your injured employee on the necessary documents and paperwork
- Report the injury and submit the claims form
- Wait for the insurer to approve or deny the claim
- Give sufficient time for the employee to recover and return to work
When is the right time to file a workers’ compensation claim?
Before filing for a workers’ compensation claim, you must ensure that all details regarding the accident are true and that they meet the requirements for covered incidents outlined in the policy. Specifically, you must ensure that the claimant is a legitimate employee of your business and that they became ill or injured while performing their duties. It’s also important to ensure that your workers’ compensation policy is up-to-date.
Conclusion
Business owners need to conform to the laws and requirements regarding workers’ compensation policies. Follow the necessary steps and submit the required documents on time, and the process of filing a workers’ compensation claim should go smoothly.
About Rodrian Insurance
Rodrian Insurance specializes in giving you insurance solutions that perfectly match your business and personal life. We provide insurance options that offer excellent coverage while remaining within your budget, based on a thorough understanding and assessment of your needs, circumstances, and financial capability. Find out more about how Rodrian Insurance can fulfill your insurance needs. Call or text us at (262) 781-4750 or email us at info@rodrian.com.
