Workman's Compensation Cases

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The best course of action is to start off with reporting your accident and filing a claim either the day of or day following the accident. Even small injuries should be reported, just in case they become problematic later on. Prompt action is needed for the best and least complicated care. Communication with your employer is key. Once the claim is filed, visit a doctor or physician (per your workman’s compensation representative’s discretion). Knowing your rights is also essential to ensure you’re getting the care you deserve. While filing and informing your employer right away may seem unnecessary, failing to do so may result in a rejection of your claim by the insurance company or the workman’s compensation court.

1. Tell your employer - While this seems like an extra or even embarrassing step, it is crucial to tell your employer and make a written statement about your injury within 72 hours. The employer is responsible for giving you the paperwork, documenting your claim, and following your restrictions to ensure you get proper care. If you fail to tell them in time, a claim cannot be made.  

2. See a doctor or physician approved by your employer’s insurance - While you may have a different primary care doctor than the ones listed by your claims representative, visiting someone out of network can result in out-of-pocket costs. The insurance typically will not cover any procedure done by someone out of network, so avoid going there unless the provider specifically states in writing that it is acceptable. If it is in-network, your employer should cover all costs. If they don’t, inquire about said costs. Setting up a consultation with an attorney can help you determine if the billing is legal. 

3. Document any and all doctor visits and report them to your employer - Keep your boss informed at all times and be sure to let them know of any changes. Give them a copy of the medical release sheet from your doctor to let them stay up to date on any restrictions. Keep in mind that they are required to follow any restrictions directed by your doctor. 

There are several reasons your claim might be denied, not all of which you are at fault for. If there is a delay in reporting and filing your injury claim it may be denied (yes, this on you). A couple other reasons that may cause it to be denied is a lack of treatment, for example if you neglected to go to a doctor to inspect your injury and determine treatment, this could cause it to be denied. Another reason it may be denied is if your employer or the insurance provider doesn’t feel your injury happened at your workplace. If this occurs, contact an attorney to see if it’s possible to rebut the denial and get your claim settled.

  The last thing you want to do is injure yourself more. If they cannot provide for your restrictions, then they must allow you time off that is paid for a portion of your wages. If neither of these is applicable, contact an attorney immediately as this is against your rights.