Workers Compensation Insurance Claim Guides

Workers compensation insurance is in place to protect you if you are injured or become ill while doing your job. Benefits include having a portion of your wages paid as well as having medical bills related to your illness or injury paid. Knowing whether or not you are eligible for benefits, filing claims and fighting possible denial of benefits can get very confusing. This information is designed to help you understand the basics of how workers compensation works.

Workers Compensation Claim Definition

A claim for workers compensation benefits is a formal request to receive the benefits you are entitled to in your employer’s workers compensation insurance policy. Your part of the claim is to verify that you were injured while working or became ill as a result of your work. You will need to produce medical records of your injury or illness and possibly a statement from your physician with their assessment of your injury.

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Workers Compensation Benefits Eligibility

It is required by law that all employees are covered by their employer’s workers compensation insurance policy. You are eligible for benefits if you are injured at work or become ill because of work. The list of possible conditions is very long, but injuries from falls, equipment injuries, repetitive motion injuries, and back injuries from lifting are among the most common. If your illness or injury is a direct result of your responsibilities at work, you are eligible for benefits.

Filing the Claim Does Not Require an Attorney

In most cases, workers compensation claims can be easily verified and the employee receives the benefits to which they are entitled. Claims may be delayed while more information is gathered, but eventually paid. In these instances, an attorney does not need to be hired. If the initial claim for benefits is denied, an appeals process should be in place so that an appeal can be filed. You will probably need to add more evidence to your initial claim to prove your injury or illness is work-related.

If you’re appeal is denied, every employee has the right to have their case heard by the state’s Workers’ Compensation Board, or an administrative law judge associated with the board. Again, if you get a hearing with the Worker’s Compensation Board, it is recommended that you present additional evidence to strengthen your case.

When to Hire an Attorney

If your claim for workers compensation benefits is denied by your employer or their insurer, and you are told that the process is closed, it may be time to consult an attorney. If you believe that you have a legitimate claim for benefits, an attorney specializing in workers compensation issues will be able to offer advice on the next steps you need to take, including filing additional appeals with state boards, or possibly filing a lawsuit to attempt to get you benefits. Workers compensation attorneys are experienced in helping you strengthen your case through further testing and other avenues so that you may receive the benefits you are entitled to.

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