When an employee experiences a work-related injury or illness, taking the right steps promptly ensures their well-being and keeps your business compliant. Here’s an overview of the workers’ compensation claims process.
What Is the Workers’ Compensation Claims Process?
After a workplace injury, there’s a limited time to report the incident and file a claim. Missing these deadlines can lead to a denial of benefits. Employers should train employees to report injuries immediately and be prepared to follow these steps:
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Provide Necessary Paperwork: Employees must document the details of the incident, including date, time, location, and circumstances.
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Gather Documentation: Collect statements from witnesses and supporting evidence for the claim.
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File the Claim: Before filing, give us a call at Goodrich & Watson. Our team will guide you through the process to ensure everything looks good. Once ready, submit the required forms to your workers’ comp insurance carrier.
5 Steps to Filing a Workers’ Compensation Claim
1. The Employee Reports the Injury
Employees should report injuries or illnesses as soon as possible. Immediate or emergency medical treatment may be necessary, while non-urgent care often requires using in-network providers.
2. Provide Guidance and Paperwork
Once notified, employers must:
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Inform the employee of their workers’ comp benefits and rights.
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Provide a claim form for the employee to complete.
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Submit any required first report of injury forms to the state workers’ comp board.
Including workers’ comp information in new hire packets can prevent confusion and legal risks.
3. File the Claim
Employers are responsible for filing the completed claim form and supporting documents with the insurer. Additionally, some states require reporting all workplace injuries, even if no benefits are sought.
State laws vary, but most require claims to be submitted within 7 days.
4. Insurer Decision
The insurer reviews the claim and determines approval or denial:
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Approved Claims: The insurer covers medical costs, lost wages, or disability payments. Employees may negotiate settlements if needed.
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Denied Claims: Employees can request reconsideration or file an appeal through the state workers’ comp board.
5. The Employee Returns to Work
When cleared by their doctor, employees must notify their employer and the insurer of their return-to-work date. Modified duties or alternative assignments may be offered as part of a return-to-work program.
When Should You File a Workers’ Compensation Claim?
File a claim if:
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The injury or illness occurred on the job or was caused by work conditions.
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The injured worker is an eligible employee under your workers’ comp policy.
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Your business has an active workers’ compensation policy.
Workers’ Compensation Coverage with Goodrich & Watson Insurers
At Goodrich & Watson Insurers, we help business owners navigate the complexities of workers’ compensation in Hampton Roads, VA. From ensuring compliance to providing comprehensive coverage, our team is here to protect your employees and your business.
Contact us today to learn more about workers’ comp and other business insurance solutions tailored to your needs.
