The workers’ compensation process will vary depending on the employer and worker. However, there are seven key steps that take place, no matter the claim.
Let’s go through each one to ensure you’re making the right strides toward getting the workers’ compensation you are entitled to.
Breaking Down the Workers’ Compensation Process
These seven steps to workers’ compensation will help serve as a guide. Ultimately, their purpose will help you make sure you’re taking the appropriate steps to successfully submit your claim. Plus, they give you a greater understanding of what responsibilities you’ll have during each stage.
Step 1: Reporting the Injury
When you become injured on the job, you must report it immediately. This kicks off the process of helping you to get the compensation you need to pay for any future expenses. It also ensures that you have all the relevant information you need to be documented and handed off to the right person, so you can get your workers’ compensation as soon as possible. Your employer should always make it known to who to report an injury. This person could be someone in human resources, sometimes, a health and safety representative, or even a manager.
Step 2: Receiving Medical Treatment
Depending on the severity of your injury, your treatment may vary. In some cases, your injury may be minor enough to only need onsite first aid care. In other, more severe cases, your injury may require immediate emergency care at a hospital.
Your employer and their insurance carrier may designate the network of medical providers that should be utilized. Depending on what state the injury occurs in, the medical treatment may change as well.
Step 3: Employer Reports Injury
After you report the injury (Step 1), it’s the responsibility of your employer to report it and provide relevant documentation to their workers’ compensation carrier. If your employer refuses to submit your claim or threatens your job, contact Erwin McCane & Daly.
Step 4: Carrier Sends Info Packet to Employee
After your employer’s workers’ compensation carrier receives the information they need, they’ll send you a packet. Within this packet, you’ll obtain information about your claim and the process. You may be asked to sign off on the release of medical records to the carrier.
Step 5: Carrier Accepts or Denies the Claim
Now that you’ve reported your incident and gotten the care you required, your employer’s workers’ compensation carrier will investigate the claim. Ultimately, they need to determine that the injury occurred within the course and scope of employment, as they want to ensure this isn’t fraudulent.
Step 6: Personalized Return to Work Plan
During this step, the injured employee, employer, and carrier will work together to develop a personalized return-to-work plan. This plan should consider both the employee’s and employer’s needs. Your doctors may be contacted in this process to help better determine what physical and other limitations you may have. Their insight will be helpful in how long the recovery will take.
However, if your employer or their carrier is pushing you to do more work against your doctor’s recommendation, you may need to contact a workers’ compensation lawyer to ensure your needs are being met.
Step 7: Case Closes and Employee Returns to Work
When an employee reaches maximum medical improvement, they’ll return to work and be released from further care by their authorized treating physician. Yet, it’s important to note that in some cases employees may not be able to return to work. In these cases, an employee may have to be moved into a modified position, retrain for other work, or receive a settlement.
Ensure You Get the Care You Deserve: Contact EMD
Working with your employer and carrier isn’t always straightforward.
If they’re refusing to submit your claim or prevent you from getting the care you need, contact us today to schedule a free consultation. You deserve a trusted team of advisors on your side. Let us help you get the most out of your workers’ compensation benefits.
