More than 2.5 million workplace injuries are reported in the United States every year. In 2023 alone, there were 5,283 fatalities reported. The workers’ compensation program was created to provide financial compensation for injured workers regardless of fault, but it’s not instant or automatic. Workers need to file a claim and follow a specific protocol in order to get compensated.
Unfortunately, many injured employees learn the hard way that navigating a workers’ compensation claim can be complex. While employers are required to carry workers’ comp insurance, they don’t manage or process claims – that’s up to the insurance company. And that’s where things can get a little confusing. If you’ve been injured on the job, here’s what you need to know about the workers’ comp process.
Your time to file is limited
When an injury happens, anxiety and frustration can hold you back from taking swift action, but that’s a mistake. In most states, you have between 1-3 years to file a claim, which seems like a lot of time.
However, waiting to file – even if you file on time – can cause problems. For instance, if you wait two years to file a claim, you might have a difficult time proving your case if you didn’t collect evidence and see a doctor immediately after the accident. So while it’s perfectly legal to file a claim later on, don’t wait to build your case.
You need to report your injury to your employer
At the very least, you need to report your injury to your supervisor and make sure it’s documented in writing. Every company should have a protocol in place for reporting injuries. If your company doesn’t, report your injury in writing in the form of a physical letter and follow up with an email to make sure it was filed.
Document everything in detail
Thorough documentation can protect you from having your claims disputed. Never depend on your employer to document your case for you. Take detailed photos and videos of your injuries and the location where your injury took place. Gather witness statements, create an incident log, and document everything related to your medical appointments.
Quality photos often support higher settlements, especially when you can capture the hazard from multiple angles to show the full context. Detailed witness statements can also increase your settlement amount. Try to get witnesses to write down or record their experience on video as soon as possible so they don’t forget the details.
Get copies of your medical records
Request every medical record you can, from ER notes and prescriptions to consultations, diagnoses, and test results. You’ll need these to prove your case.
Don’t agree to light duty so fast
After filing a workers’ comp claim, some employers offer light-duty roles that only pay half of your claim. But under the workers’ comp system, if your injury limits your ability to work, you’re entitled to approximately two-thirds of your wage difference, not some arbitrary number your boss offers.
Check with a workers’ compensation attorney before agreeing to light duty and a lower payout. For instance, most states require payment of 60-66% of lost earnings. And never agree to perform tasks that your doctor says to avoid. For instance, if your doctor says you can’t lift anything for a period of time, don’t accept a light duty role that requires lifting.
Appeal if your claim is denied
If your initial claim gets denied, appeal. There’s a good chance your appeal will be approved. According to research, 67% of appeals are paid within a year. Best of all, that same research shows that appeals often settle for 55% higher than the original claim. Usually, higher compensation is the result of having legal counsel during the appeals process. Don’t hesitate to hire an attorney to fight for what your claim is worth.
Plan your comeback
Don’t try to come back full force because you might reinjure yourself. Ask for transitional duty first to make sure you can handle it. Get support from your doctor with an official document stating what you can and cannot do and for how long. For example, maybe you aren’t supposed to lift more than five pounds for a month, or you can’t lift at all.
Stay in control of your workers’ comp claim
Once you’re injured at work, your employer won’t necessarily tell you everything you need to know. Don’t depend on them for information or support. You have rights, so stand firm in your decision to file a claim, appeal if you get denied, and hire a lawyer to get a more favorable outcome.
