Getting your workers’ compensation claim paid is essential, particularly if you have medical bills, lost wages, and other expenses to cover with these funds. Unfortunately, it can sometimes take weeks or months to see any money from your workers’ compensation claim. If it’s been a while since you’ve heard anything about your claim and you don’t know what to do, this guide can help.
Figuring Out How To Find the Status of Workers Comp Claim
Although the claims process and timeline vary among injured workers, finding out the status of your claim is standard. It’s normal to feel like the system is moving too slowly, especially when funds are low. Even though you can check the status, you may not be able to do anything about how long it takes. The state where the injury took place controls distributing the funds, and putting an urgent rush on government matters is rarely successful. However, it’s important to know where to look for information on your claim status and how to ask questions and get results. You should also know how the claims process works.
Legal Grounds for a Workers Compensation Claim
If you suffered an injury at work, you might be entitled to certain benefits. Every company in the United States, except for Texas, requires employers with a certain number of employees to carry workers’ compensation insurance. This is a special insurance program paid for by an employer to cover the costs associated with workplace injuries. The nature of the work-related injury doesn’t matter, such as if the employee was at fault or the company was negligent. An injured worker has the right to seek compensation from the employer through workers comp.
The insurance company has specific areas of coverage or allowable benefits, but there are also restrictions concerning where injured workers can go for medical care. An authorized provider is a physician approved by the state to treat an injury. In some cases, referrals are necessary, and these must come from a licensed physician. Although the insurance company and your employer can dictate where you must go for treatment, they can’t deny you coverage.
Process for Filing a Workers Compensation Claim
In many places, you have a limited window for filing a workers comp claim. The timeline varies from state to state for reporting the injury to your employer and filing a claim. In many states, the initial injury reporting deadline is 30 days, while filing the claim could be one to three years. Promptly reporting an injury not only benefits your health and wellness because you gain access to medical care, but it also benefits your worker’s compensation claim. A delay in reporting injuries is often cited as a reason for claim denial.
Claim Process
The first step in the process is reporting the injury to your employer. Because the reporting deadline varies, it’s essential to check with your state laws or employer on the exact amount of time allowed. It’s in your best interest to report the accident and injury right away. The sooner you file your claim, the sooner you will see your benefits. Even if you don’t think the injury was severe, ask to see a doctor. Some injuries, such as a concussion, muscle sprains, or internal bleeding, don’t show up for several hours or even days. If you need immediate attention, you should be taken to the nearest emergency room. For other injuries, you should make an appointment with a doctor from the approved list of providers.
Once you report the injury, the claims process starts. The employer should provide you with official forms to fill out. Some company-specific paperwork may be included, but forms are required by your state’s workers’ compensation board. It is generally the employer’s responsibility to submit the paperwork to the state. If your employer refuses to provide you with the paperwork, you can contact your state’s workers’ compensation agency directly. At that point, you may also want to consider calling an experienced workers’ compensation attorney.
Claim Number
Your paperwork will list your claim number or your employee ID number. This varies according to your state’s process. You should keep a copy of all the paperwork you sign and submit, but you can also write this number down. It’s what you will need to find out your workers’ compensation claim status. Your form may have two claim numbers, one for the workers’ comp claim and the other for dealing with the insurance company.
Claim Benefits
It’s standard for workers comp to take care of medical expenses, lost wages, ongoing expenses related to rehabilitation or medications, and funeral expenses if the injury or illness leads to death. Unfortunately, many benefits will only pay out a percentage of your income. Again, the specifics vary by state, but it’s common to expect your compensation payments to be less than your paycheck. For many, this cut in pay affects their ability to cover everyday living expenses. This is why an attorney is so helpful. A lawyer can help negotiate the payment you deserve.
Checking on Your Claim for Workers Compensation
Before you can check on your claim, you will need your claim or employee ID number. If you choose to get a copy of your paperwork, you will find the number there.
Step 1: Gather your claim information and number.
Step 2: Navigate to the website operated by your state’s workers comp board. Your paperwork may include this URL for easy reference. If you cannot find the website, you can call or email the claims examiner assigned to your case and ask for the information.
Step 3: Follow the prompts on the website to check the status of your claim. It could also be labeled check your benefits or find a pending claim.
Step 4: Enter the requested identifying information. Some websites will only ask for your claim number, while others may want to verify your identity. The site might request your birthday, the last four digits of your social security number, or another pin.
Step 5: Review the report. Each site is different, but you will generally see a summary of your claim and the current status. If you check the status and it says “denied,” there are a few things to do next.
Step 6: If your claim status is denied, you have the option to appeal the ruling. You may want to contact an experienced attorney since there are deadlines for appeals and potentially the need to submit additional paperwork. You should receive a formal denial letter with additional information on how to appeal the decision.
If your claim is still pending, you may want to call the claims examiner to ensure all your paperwork has been filed. If the claim is approved, you should take a moment to verify that your information is correct.
Reasons for Delayed Workers Comp Claim
It’s common for a claim to be delayed. This means the process is taking longer than expected, often due to a few reasons. These include:
- Employer delays- Your employer didn’t follow the proper reporting or filing process. It may also be an attempt to ignore your claim to avoid having to provide payment.
- Insurance company delays- The insurance company may be slow in processing your claim because of staffing issues, such as poorly trained staff or being understaffed. The claim could also be delayed in an attempt to negotiate a much lower settlement offer.
- Paperwork delays- If there are mistakes on your claims paperwork, it could delay processing. Any omissions or errors could trigger a request from the insurance company for reviewing and resubmitting the forms with the necessary or omitted details.
Get Answers to Your Questions About Workers Compensation Claims
Without the right resources, you may end up with a significant delay in receiving your payments or find your compensation was denied outright. By calling 1800AskGary, we can connect you with experienced attorneys who can explain the workers’ compensation process and your rights. Contact us today to find a trusted workers’ compensation attorney in your area.
