Lawyer Up: A Smart Decision for Workers Comp Claims

When you are hurt in a work related accident, you may need to file a workers compensation claim.

Whether you had a construction site accident, slipped at work, or had another type of accident, you may need to contact a workplace injury lawyer in Philadelphia to help with your pain and suffering from the accident. Workmens’ comp can be complicated and trying to handle it on your own is hard.

Rather than handling it all on your own, you should consider a work injury lawyer in Philadelphia. The right workers comp lawyer will know how to handle all of your claim and can walk you through all of the steps that need to get done. After an accident, make sure to contact us to get set up with the right work injury lawyer in Philadelphia.

How Does the Claims Process Work?

If you have been injured, you may be curious what steps you need to take to get compensation for the injury and any time off work or medical bills due to that injury. After the accident occurs, there is a limited time frame where you can submit your paperwork and get these benefits. This is done to make sure a company is not paying out benefits years after the accident occurs.

Both the employer and the worker need to act promptly when this injury occurs. If they fail to do so, the claim may be denied. There are certain steps that the employee and the employer need to follow after the accident. These include for the employer:

  • Give the employee the right guidance and paperwork for the case.
  • File the claim with their insurer.
  • Comply with all of the local and state laws for reporting these work injuries.

The employee must finish certain tasks as well. For example, some of the things that are the responsibility of the employee include:

Notifying the employer that the injury occurred. The more details the better here including how the injury occurred, the type of injury, the time and the date.

The process used for worker’s compensation will vary based on where the job is and where the employee is located. This type of compensation is regulated through the state so it will really depend on where you live.

When Should I File a Claim?

As an employee you should file one of these claims if you sustained injuries while on the job or while doing work that is in the scope of your employment. This could include things like illness, injuries from trauma, disease, and occupational accidents that are caused when you perform your regular work activities or when chemicals are present.

For you to file one of these claims, a few things must be true. These include:

  • The employer has a policy for worker’s compensation in place.
  • The person who is injured is an employee of the business. They can’t be a freelancer or a contractor.
  • The employee must get injured while performing their job.

If all of these are not true, then this compensation is not provided or available and you can’t work on a claim. This means that if you are a contractor of the company rather than a regular employee, you are not able to file this claim.

How to File A Workers Comp Claim

There are a few steps that you will need to follow to make sure the claim is filed properly and you receive the compensation that you deserve. If you need help with any of these steps, a worker’s compensation lawyer in Philadelphia can step in and help you get it done while representing you through the process. Some of the common steps that happen with a workers comp program, though it may change based on the state you reside in, includes:

The Employee Reports the Injury

Before you can make one of these claims, the illness or injury needs to be related to work. There are many injuries that can count here including developing cancer from toxic substances at work or slipping on some ice in the parking lot. If there is an emergency situation, that employee needs to be rushed to the ER of the nearest hospital. If the injury is less severe, they can go to their regular doctor and get a diagnosis. Make sure to get a copy of the medical report to add with your claim later on.

Depending on the specific state where the accident happens, the injured employee may need to visit a specific medical provider, one that is within the insurer’s network, before they can get any benefits. Along with this, the employee needs to provide the employer with a written notice that they were injured at work as soon as they can. There are limits on this so you must check your local state. New York only gives 30 days for this notification though some states may give a year or more.

The Employee is Given Proper Paperwork

After the employer is notified about the injury, they are responsible for helping them get the case going. Some of the things that the employer needs to give to the employee includes:

  • Any relevant information required before returning to work.
  • Information that lets the employee know about the benefits offered their workers’ comp and their rights.
  • A form to report to the state workers’ comp board if this is required in the state.
  • The right forms to report this workers’ comp case.

There are different papers necessary based on where the work is done. Sometimes the claim is done directly to the insurance provider for the company and other times it needs to be done through the state instead. If possible, the employer should provide this information before the employee goes to get treatment. There are times when this information is given in a new employee packet as well.

If this information is not provided to employees when they are injured, the company is open to a lawsuit. This means that if you do not receive this paperwork, contact a workers’ compensation lawyer to help you out. We can work with you to figure out your rights and get you the right compensation, even if you did not get the right forms.

The Employer Will File the Claim

The employer is usually the one who will file the claim and submit all of the paperwork to their insurance carrier. Your doctor will need to send in the medical report though to help finish the claim. Employers may need to submit certain documentation to the compensation board for the state. This may apply to all of the injuries that happen at work, regardless of whether the employee is seeking benefits or not.

The Insurer Makes a Decision

Once the claim is all filed, it is up to the insurer to make their determination about the claim. If they approve the claim, then the employee will be contacted to hear about the payment details. However, if the insurer doesn’t think that the claim qualify, then the benefits will be denied.

If you have a case where your workers compensation claim is denied but you still believe you have a good case, then it is time to contact our team. We are the right workers compensation lawyers to help with your needs and can review your case and handle any appeal if necessary.

The remainder of the process is going to occur between the employee, their doctors, any legal representation that they have, and the insurance company. If the insurer does approve the claim, some of the things an employee can do, with our help, includes:

  • Accept the offer of payment. This may help cover the cost for medicine, medical bills, disability payments, and some of the wages that they lose for not being able to work.
  • Negotiate to get a lump-sum settlement. Sometimes it is possible to negotiate and get a larger amount with the right legal team.

There are times when the insurer will deny the claim and refuse to pay out any benefits at all. When this happens, the employee has a few options as well including:

  • Asking the insurance to review the decision, bringing in more information if necessary.
  • File an appeal with the help of your legal representation to get the best result.

In both of these situations, the insurance company is going to be responsible of notifying the workers’ comp board of the decision that it makes.

The Employee Will Go Back to Work

The employee is then responsible for notifying the insurance company and the employer, in writing, when they believe they are recovered enough and they want to go back to work.

Depending on the type and the severity of the injury that occurred, the insurance company may be willing to continue to pay some of the disability benefits even when the employee goes back to work.

It is possible that the employee continues to have occupational injuries, the premium for workers’ comp for a company may increase. To avoid these injuries and any increases to the premium, employers need to make sure that they maintain a safe work environment and that all employees are trained well. This will ensure that all workers are able to perform their duties in a safe and effective manner.

What Won’t Workers Compensation Cover?

While there are many things that worker’s compensation can help cover to keep you protected and safe after an accident, there are several things that worker’s compensation will not cover at all.

Knowing what these are ahead of time will help you make a better claim and can prevent a lot of wasted time as well. Some of the things that worker’s compensation is not likely to cover includes:

  • Injuries that occurred while you were committing a crime, under the influence of alcohol or drugs, or when you were violating the policies of a company.
  • Injuries that you incurred while on the commute to and from work.
  • Injuries that occurred when you were messing around at work or fighting.
  • Injuries that you did on purpose to yourself.
  • Stress and other psychiatric injuries.

If you are uncertain about whether you should file a worker’s comp claim for any injury you suffered from, it is best to contact a local injury lawyer in Philadelphia to help you out. They can answer all of your questions about the injury and will make sure you get your case going well.

Should I Hire a Philadelphia Work Injury Lawyer?

In an ideal world, you would never get hurt at work and you would never need to deal with worker’s comp. And when you did get hurt, the insurance company would be understanding and provide you with the compensation that you need without the hassle. But since we don’t live in an ideal world, and it is not uncommon for the insurance company to deny your claim or offer you too little after the accident, working with a local injury lawyer in Philadelphia is the best way to ensure you get the compensation that you deserve.

Working with workers’ comp on your own is confusing and a challenge. There are a lot of rules to follow and many times you can be denied without ever being told why. With the right representation along the way, you are more likely to get enough compensation to help you cover the time you are not at work and all of your medical bills, along with pain and suffering from that accident.

A Philadelphia work injury lawyer is your best resource to make sure that you reach a fair settlement that helps handle all of your work injuries and pain and suffering. Working with a local injury lawyer in Philadelphia is one of the best ways to make sure you take care of your claim and have the right understanding of local laws. When you need help with your workers compensation claim, contact our law offices right away to get started. “We Win or It’s Free” ®

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