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After an injury, what is the workers’ compensation process?

On Behalf of | Jun 24, 2021 | Workers' Compensation

Getting hurt on the job is likely a nightmare scenario for you. Over the years, you may have seen other workers suffer injuries, and you hope you will never find yourself in that situation. Unfortunately, even after doing your best to be a safe worker, unforeseen circumstances can leave you with a work-related injury.

After suffering an injury, you need help to cover your medical bills and the lost wages that you face while recovering. If your New York employer has workers’ compensation insurance, you should be able to file a claim with your employer in order to obtain those benefits. However, your employer has obligations to meet during this process as well.

What should happen?

You must tell your employer about your injury immediately. Although specific employer responsibilities vary by law from state to state, generally speaking, employers have a responsibility to see that you receive the necessary medical attention and report the injury to the insurance company. Of course, your well-being is the priority in such a situation, so your employer should first contact emergency services or take other action to ensure you receive care.

After addressing your medical care, your employer should report the incident and injury to the insurance provider within 24 hours. Your employer should also take the following steps:

  • Fill out a First Report of Injury form to document the situation with the insurance carrier to start the workers’ comp claims process
  • Tell the insurance carrier vital details about the event, including the date and time of the incident, how the injury occurred, where on the body the injury occurred, your name, where you received medical treatment and more
  • Ensure that the insurance provider reviews the case as necessary

After these steps, the insurance provider decides whether to approve or deny the workers’ comp claim. In the event of an approval, the provider will offer you compensation, which you can accept or refuse. If the insurer denies your claim or offers inadequate compensation for the damages you experienced, you may need to appeal the decision or move forward with legal action.

A denied claim

Unfortunately, denied claims are not unusual when dealing with workers’ comp. In some cases, employers provide incorrect information or even falsify facts to avoid liability.

In other cases, the employer may not file the proper forms or report the matter to the insurance company promptly. Whatever the reason, you have the right to review the situation and determine whether taking legal steps could help you receive the benefits you deserve.

Seeking the help of an experienced workers’ compensation firm can help in determining whether the employer and carrier appropriately handled your claim consistent with the law in the state where you were injured.