Workmans Comp Claim Tips…

Part 2: Tips for Filing Your Injury Claim…

When filing a workmans comp claim there are a few things you should keep in mind. The laws and regulations governing these types of cases can be complicated.

Don’t be caught by surprise by forgetting to do the few simple things on this page.

If you become injured while working and your employer has in place a workers compensation insurance policy, you should follow these tips to help secure your claim…

Tip #1: Notify Your Employer Immediately…

If you get injured don’t wait too see if the pain might go away. Different states have varying rules and regulations for reporting on-the-job injuries, so if you were injured on the job report the injury immediately. Failure to do so might result in a loss of benefits.

If you were injured on the job and at the time of the injury chose not to report it, otherwise known as the “tough guy syndrome,” you may be looking for trouble. Let’s say a significant amount of time has passed since you injured your back and you continually refused to report it. Weeks later your back starts to swell and you start feeling excruciating pain. You knew you were hurt when the injury first occurred but ignored the discomfort. Just then you realize the time limit to file a workmans comp claim has passed. You now may have to pay all your medical bills by yourself. Don’t make this mistake!

Since initial notification time frames to file a workmans comp claim vary from state to state, it’s vital you become familiar with all the time frames related to your state’s workers compensation act. Read your Employee Manual carefully. Make it a point to speak with your company’s workers comp administrator. Knowing ahead of time what to do in the event of a work related injury can save you valuable time and money.

Tip #2: Fill Out the Employer’s Claim Form Completely…

Make sure when reporting the injury you completely and legibly fill out the workmans comp claim form given by your employer. Remember, this form is the first formal notification you are giving your employer. Not completing it fully or writing unintelligently can only serve to slow down the compensation process. The claim form should have a place to write your:

  • Full name
  • Date of birth
  • Social Security number
  • Mailing and residence addresses
  • Telephone numbers (cell and home)
  • Email address
  • Date and time of injury
  • Description of what caused your injury
  • Description of circumstances surrounding your injury
  • Names and contact information of any witnesses
  • Names and contact information of your treating physicians
  • Any medical treatment you received, including ambulance and emergency room treatment

Tip #3: Give the Workmans Comp Claim Form to the Proper Person…

Make sure you know who to submit the claim to. It may be the person who supplied the injury claim form to you, or it may be another employee workers compensation representative.

Tip #4: Closely Follow Your Treating Physician’s Orders…

If your treating physician tells you to take a certain period of time off to recover you should do it. While doing so make sure to maintain contact with your employer or her appointed representative. Failing to keep contact may result in a denial of some benefits.

Tip #5: Don’t Overstay Your Welcome…

If your treating physician indicates you should stay home for a certain amount of time, and you decided to stay home even one day longer, you may forfeit your right to lost wages for the additional time you stayed home.

Tip #6: Choose a Physician From the List Provided By Your Employer…

Although each state has its own rules and regulations regarding choice of physicians for workers compensation injuries, you should choose a physician authorized by your employer. Employers have a list of authorized physicians specifically for workmans comp claims.

Depending on your state’s workers compensation laws there may be three or up to six authorized physicians on your employer’s list. Going outside of the list without prior authorization from the insurance claims adjuster may result in a denial of payment by the workers comp insurance company.

Tip #7: You Can’t Be Reprimanded or Fired for Filing a Claim…

Do not be afraid to file a workmans comp claim, you can’t be reprimanded or fired. It’s against federal and state law for an employer to fire an employee for filing a workers compensation claim. However if you are permanently injury or injured in a way that prevents you from doing your job, your employer does have the right to replace you.

Tip #8: Be Sure to Use the Authorized Pharmacies…

When filling prescriptions be sure to use the pharmacies authorized by your employer or the insurance company’s representative. Even though prescriptions are covered by your workers compensation insurance, they may not be if you go outside the pharmacies authorized by your company.

Tip #9: Look Before Leaping…

If you don’t like the employer directed physician do not simply choose a physician of your choice. Doing so may jeopardize your benefits qualification. Your employer is required to maintain a list of physicians from which injured employees may choose.

With that in mind, go back to your employer or her designated representative and ask to see additional physicians who are on the list. Choose another and see if the new physician is more to your liking. Be sure to fill out any additional forms your employer may require.

If after ninety days you are still unhappy with the treatment afforded you by the physicians on your employer’s list, you may choose a physician who’s not on the list. Be sure to notify your employer or the insurance adjuster before you do.

Tip #10: Keep Records of All Expenses Related to Your Treatment…

Your out-of-pocket expenses are generally reimbursable. Keep receipts for parking lot fees, bandages, over the counter medications, and the gasoline burned while doing all that driving. These days with the high price of gasoline, keeping track of your out-of-pocket expenses while traveling to your physician, employer, or claims adjuster is no small matter.

Keep a log of your mileage and the gasoline purchased to drive to the various medical facilities, pharmacies, and the like. As your workmans comp claim proceeds be sure to keep your adjuster apprised of the additional costs, and when requested send copies of all of your documentation (including copies of the gasoline log entries).

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