An Employers Guide To The Worker Compensation Claims Process

As an employer, your primary responsibility to ensure your employees healthy and safe working environment. However, there are instances when workers get injured or become ill due to work. This is where the workers compensation insurance program enters the picture.

Under this program, employers must buy insurance coverage that provides medical and wages replacement benefits to workers who sustained an injury or illness due to their jobs. Regardless of who’s at fault for what happened, the injured or sick employee can get compensated. But before they can recover compensation, you need to file a claim on your employees behalf.

Keep reading this article to familiarise the employers guide to the workers compensation claims
process.

businessman in blue jacket giving form for compensation claim to

businessman in blue jacket giving form for compensation claim to worker with broken arm at table in office, compensation concept

What Is Workers Compensation For Employers?

As mentioned, workers compensation insurance is designed to compensate employees who are injured or become at will. Some injuries and illnesses covered by this insurance coverage can include sudden accidents, repetitive stress injuries, occupational diseases caused by workplace
conditions, and many more.

Hence, if you want to provide financial assistance to your injured or ill workers, you should carry workers compensation right from the start. Failure to do so can result in some legal consequences. For example, suppose you don’t have insurance coverage. In that case, your injured or sick employee can sue your business with the help of a lawyer from a reliable law firm like Terry Katz and Associates. When this happens, you’d need to hire a lawyer to represent and defend your company against the suing worker.

Steps To Navigate The Claims Process

Now that you know what workers compensation is for employers, the next thing you can do is familiarise yourself with the steps associated with the claims process. Under the workers compensation insurance program, you’re responsible for filing the claim to your insurance
carrier.

To make sure the claim is filed correctly, below are a few steps you need to consider from the
get-go:

1. Remind Your Employee To Report The Injury

To make the claims process as smooth as possible, you need to ensure your employee reports in writing the injury or illness to you as soon as possible. Although the notification time varies from

one state to another, the standard timeframe would be within 30 days from the date of the accident or sickness.

Generally, prompt reporting of what happened is crucial for the claims process. When workers fail to do so, they may lose their right to compensation under the insurance program.

2. Help The Employee With The Paperwork

After being notified, you should assist the employee with completing the necessary paperwork. For example, you need to inform them about their rights under the workers compensation program. Make sure to provide them with forms to fill out. These can include the workers comp claim form and the report of injury form, which should be submitted to your state workers compensation board.

When it comes to filling out the claim form, make sure the employee writes down all the details, including the nature and type of the injury as well as when, how, and where it occurred. This way, you can ensure a successful filing later on.

3. File The Claim Form

Once your employee fills out the claim form, the next step you should take is to file the claim form to your workers comp insurance provider. In doing so, you may need to submit some supporting documents, including a medical report from your employees doctor. These pieces of documentation may be necessary to support your workers claim and increase their chances of receiving compensation.

4. The Insurance Carrier Will Either Approve Or Deny The Claim

After the filing, the insurer will review the forms submitted and determine whether the employee should be granted the benefits or not. If they approve the claim, they’ll notify you and the employee with the payment details. Your worker and their lawyer will step in the process by accepting the payment offer to cover benefits or negotiating a larger settlement offer.

On the other hand, if the insurer denies the claim, the employee will be notified. At this point, they have the option to file a motion for reconsideration from the insurer or institute a formal appeal with your states workers comp board.

5. Your Employee Returns To Work

When your employee is injured or sick at work, they’re given ample time to heal. Once they’re done with the recovery, they should notify you and the insurance carrier in writing that you can return to work.

When this happens, you can provide some programs to help the employee get back to work productively. For example, you can give them some training in other job positions if they can no longer perform their regular functions because of the injury or illness.

Bottom Line

Sometimes, your employees can sustain injury or sickness at work. When this happens, you should be ready to support them financially, emotionally, and mentally. This is one reason you should have workers comp to ensure financial protection to your workers and avoid potential non-compliance issues that may affect your business.

However, if you need help navigating a workers comp claims process more efficiently, keep this guide in mind. By doing so, you’ll not only make the entire filing process much easier and faster, but you’ll also improve your employees chance of getting compensated.

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