What Is a Workers Compensation Claim?: The Basic Facts You Need to Know

Posted September 15, 2020 by in Lifestyle
workers comp

You go to work each day expecting to do your job, get paid, and repeat the next day. Yet, on this particular day when you went to work, things didn’t go as planned and now you’re injured.

Now you’re worried about your injury, worried about healing and getting back to work. You need your job to pay your bills and now you have this injury to contend with.

If you were injured on the job, you need to talk to your boss about a worker’s compensation claim. What is a workers compensation claim? Your employer’s required to carry workers comp insurance to protect you for a situation just like this.

Read on to learn about the process of filing for workers compensation.

What’s Covered With Workers Comp

Before covering the claim process, let’s cover what is covered under a worker’s compensation policy. Most states require businesses to carry some form of workers comp insurance. It protects both the worker’s rights and the employee in the event of something going wrong at work.

Under most policies, there are four areas covered.

First, a policy will cover medical expenses related to the injury. You go to the doctor or emergency room and the care you receive falls under the workers comp policy. Any prescriptions, tests, hospital care, or physical therapy from the injury or illness gets covered.

An employee can also get a disability payment during their recovery time. This would pay them part of their normal wages while they recover before they can return to work.

Workers’ comp policies also cover training as needed. In the event, the injury prevents you from returning to the same work, they would train you for a different job.

Finally, the policy offers death benefits to beneficiaries if the employee died as a result of the workplace injury.

What Is a Workers Compensation Claim?

The workers compensation claims are made following the injury or illness at work. Your employer’s required to carry this insurance. The claim process is very specific and must be followed carefully to avoid getting a workers compensation denial from the insurance company.

Process to File a Claim

The employee should report the injury to the employer in writing as soon as possible following the injury. In an emergency situation, the employee would get medical care, then officially report it. In a non-emergent situation, the employee reports it. The employee may be asked to see an approved doctor.

The employer’s required to provide paperwork to the employee so they can file the claim. Once the employee has the paperwork, they fill out their part. Often the treating doctor will need to complete paperwork for the claim. The employer files the claim and the paperwork is gathered from the employee and the treating medical professionals.

Then the insurer looks at the information related to the claim and decides whether to approve or deny the claim. To avoid a denial, it’s important to follow the steps and timelines carefully.

Understanding Workers Comp Filing Process

What is a workers compensation claim? It’s a process under the worker’s comp insurance policy carried by your employer to protect the employee in the event of a workplace injury or illness.

It’s important to pay attention to the requirements of the claim process to get your claim approved.

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