What Does the Workers’ Comp Process Look Like?


Most states across the US have requirements for businesses to carry some form of workers’ comp insurance. This insurance protects businesses from expensive liability.

Mostly, it protects workers in case they are injured while on the job. Workers’ comp insurance makes sure workers can get the medical treatment they need from a work-related injury. They can also get lost wages if their injury prevents them from doing their job.

If you suffer an injury while on the job, it’s important to know the workers’ comp process for making a claim and getting benefits. Read on to learn what you should do if you are hurt on the job and how to make a worker’s compensation claim.

What Is Workers’ Comp Insurance?

When a workplace injury happens, there can be many side effects. For a business, the injury can create an expensive liability. It also means the worker may not be able to work while injured impacting the business.

For the worker, they are now facing an injury, recovery, and missing work. While workers’ comp insurance can’t heal the worker, it can protect the business from potentially big liability costs. It can also address the needs of the worker as a result of the injury.

It’s important that this is required for businesses, thus really protecting all workers.

How Does Workers’ Compensation Work?

When a worker is injured on the job, they must report the injury to the employer. Both the employer and employee then have responsibilities to provide information to the insurance company about the injury. In the simplest  terms, then the insurance company evaluates the claim and decides what will be paid for on the claim

What’s covered exactly under workers’ comp insurance? There are really four areas of coverage provided under the insurance plan.

First, an injured worker gets medical coverage for doctor visits, hospital care, prescription medications, physical therapy, and other medical treatments.

If the injury prevents them from returning to work, they are given money to cover a portion of their lost wages while they are out of work. This would be part of the disability coverage.

If a worker’s injury prevents them from returning to the type of job they once did, the insurance can also vocational rehabilitation training to prepare them for different work.

Finally, in the event a worker is killed on the job, death benefits can be provided to their heirs.

What Is the Process for Filing a Worker’s Compensation Claim?

If you are injured on the job, it’s important to report your injury immediately to your employer. You don’t want an insurance company to later suggest your disability wasn’t connected to your injury at work. You also have a limited amount of time to make a claim.

Let’s take a closer look at the steps you should follow once injured to file a worker’s compensation claim.

Medical Care

The most important thing to do immediately following an injury at work is to get medical treatment right away. If your injury is an emergent one, go to an emergency room to begin getting care.

If your injury is not an emergency, you might ask your employer who to seek treatment from. Some workers’ comp policies require you to see a certain doctor for treatment.

The medical treatment you receive right away will be important for your claim. It’s also important that you follow the directives given to you from your injury. You don’t want an insurance company to later deny your claim because they believe you didn’t follow the doctor’s orders.

Notifying Employer

Once hurt on the job, you want to make sure you notify your employer of your injury.

You might have informed them verbally when the accident or injury happened. You also want to inform them in writing. It’s important that you document everything you remember from the injury. Include:

  • What is your injury?
  • Date, time, and location when the injury occurred
  • Include anyone else involved at the time of the injury
  • Medical treatment you received
  • How the injury happened

If there were witnesses to the injury or accident it’s important to document them too.

Employer Responsibilities Following a Claim

Once you have informed your employer of your injury, it’s their responsibility to inform their insurer that you are making a claim.

Your employer should provide you with the necessary paperwork to complete about what caused the injury. It will be necessary for you also to get the paperwork to your medical care provider. They need to document your injury and the treatment and prognosis.

Claim Documentation

Once you make the claim, there shouldn’t be much more for you to do. Although you want to keep track of all communication related to your claim.

It is a smart idea to record details of your injury and recovery. You want to document what work you are missing because of the injury.

You also want to make sure you are following the directives of your medical team completely. You don’t want an insurance company to attempt to deny a claim because they think you aren’t doing what’s needed for your quick recovery.

Seeking Legal Help

It’s good to remember that when you get injured your claim goes to an adjuster who works on behalf of the insurance company. The truth is the insurance company doesn’t want to pay out money and will often go to great lengths to avoid paying your claim.

It may be necessary for you to seek the help of an attorney who specializes in workers’ compensation cases. An attorney will know how to protect your interests, negotiate with the insurance company, and get you the benefits you deserve.

The sooner you opt to get a workers’ compensation attorney involved the better. They won’t need to play catch up and can immediately start addressing your claim with the insurance company.

An experienced attorney will know the workers’ comp process and be able to guide you through the steps to avoid any conflicts with the insurance company.

Get an Experienced Attorney to Help You With the Workers’ Comp Process

Getting injured at work is difficult, especially if you face a long recovery and need to miss work and lose wages. Understanding the workers’ comp process can help to make your claim get approved more smoothly.

It’s a good idea to seek the help of an attorney who has experience dealing with workers’ comp insurance companies. If you have been injured at work, we can help. Contact us today to discuss your claim. We will be happy to do a free case evaluation and get you started getting the help you need.

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