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How does a workers’ compensation claim occur?

On Behalf of | May 2, 2023 | Workers' Compensation

Workers’ compensation provides you with benefits if you suffer an on-the-job injury or illness. It is a no-fault system, meaning that you do not have to prove your case to receive benefits.

The payments you receive come from insurance your employer purchases, but the state manages the rules concerning the system. You and your employer must follow these rules to properly submit a claim.

Your paperwork submission

After your accident, as soon as possible, you must provide a completed claim form to your employer. This begins the process of getting benefits. You need to ensure you fill out the form completely and include any necessary medical forms. You also should seek treatment right away. You can choose the initial doctor you use, but the insurer may later make you see a specific provider.

Employer’s duties

Your employer must report your claim to the state and to its insurer. There are specific deadlines for making reports, so it is important your employer abides by them to avoid delaying your benefits. Your employer must ensure it has all the proper documentation required.

Insurer responsibility

If the insurer approves the claim, you will receive a notice about your benefits. There is a process for appealing a decision if you disagree with the insurer’s decision. It is the insurer’s duty to ensure you stay informed about what is happening with your claim. The insurer will also manage all payouts.

The actual benefits you get depend on your case. The insurer will decide that based on state law guidelines.