Most employees in the United States are entitled to workers compensation benefits through their employers. With this program, employers are also protected from lawsuits involving an employee’s injury. As your workers compensation lawyer will tell you, if you accept those benefits, you are required to waive your right to file a lawsuit. Essentially, workers compensation benefits are considered a substitute for filing a lawsuit against your employer. Although each workers compensation case will vary depending on the situation, there are some basic elements of a workers compensation timeline.
No. 1 – Report your injury to your employer
The first step in handling a workers compensation injury is to report that injury to your employer. You should do so immediately after the incident or, at the most, within a few days of the injury. Some employees try to “tough it out” and not report the injury officially, hoping that they will recover in a few days. This is not the right course of action. Even if you believe the injury is minor, you need to report it immediately so that you can document when the injury actually occurred. Not doing so could result in your claim being denied. If that happens, your workers compensation lawyer can help.
No. 2 – Obtain a medical evaluation from your physician
Once you report your injury to your employer, they will typically send you to a physician to determine the extent of your injuries. The physician will also have to offer an opinion about whether you are able to return to work. If your injury is too severe to allow you to return to work, or if you need to return with restrictions, then the physician can provide a report for your employer.
No. 3 – Receive necessary medical treatment
It is crucial that you comply with all of the physician’s instructions regarding treatment. Complete all treatment or rehabilitation programs. If, for some reason, you do not agree with the treatment recommended by the physician, you can request a second opinion. But, ultimately, you must follow whatever treatment plan is required, in order to receive all of the benefits to which you are entitled.
No. 4 – Reaching maximum medical improvement
Once you have completed all of the necessary treatment for your injury, you will reach “maximum medical improvement,” as determined by your physician. What this means, basically, is that your physicians have done all they can to improve your medical condition following your injury. At that point, your treating physician can evaluate you and assign a disability rating based upon any partial or permanent disability resulting from the work-related injury.
No. 5 – Participate in settlement negotiations
Once you have reached maximum medical improvement, it is time to start negotiating with your employer’s workers compensation insurance carrier for a fair settlement of your claim. You should involve your workers compensation lawyer in these negotiations to make sure the settlement you receive is fair. Negotiations could last several works or several months, depending on the extent of your injury and the willingness of the insurance provider to pay a fair amount for your injury.
The Workers’ Compensation Appeals Process
The Worker’s Compensation insurance system is based on administrative law, which means an administrative agency, as opposed to a court of law, will oversee the entire system, including any claim contest or appeal. Administrative law judges are responsible for conducting hearings which are very similar to civil trials. If your claim is contested by the worker’s comp carrier, then your next step is to seek an appeal. This is another step in the timeline in which you should seriously consider seeking the assistance of your workers compensation lawyer.
Asking for reconsideration of the decision
The steps in the Worker’s Compensation Appeals process may be somewhat different, depending on the state you work in, but here are the basic steps that everyone must take in order to appeal a decision denying worker’s comp benefits. The first step is to determine why your claim was contested or denied. If you are lucky, the matter may be resolved quickly. If you failed to submit a required document or some necessary evidence, you may be able to remedy the problem by simply supplying the required information. Once you do that, the worker’s comp carrier can reconsider your claim.
Requesting a formal appeal may be necessary
If those steps do not resolve the problem, it may be necessary to file a formal appeal, pursuant to the guidelines established by your state worker’s comp agency. Typically, the written notice of denial that you received will describe the specific steps you need to take to begin the appeal process. Be sure you read the letter carefully and make note of all appeal deadlines.
If you have questions regarding worker’s compensation claims, or any other personal injury concerns in Arkansas or Missouri, please contact the Cottrell Law Office for a consultation, either online or by calling us as (888) 433-4861.
He is licensed to practice law in the United States District Court for the District of Kansas, eastern Arkansas, western Arkansas, and western Missouri. He was Deputy Prosecuting Attorney in Crawford County, Kansas from 1987-1989.
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