What Is a Workers Compensation Claim?

According to the U.S. Bureau of Labor Statistics, 2.8 million private company employees across the U.S. experienced a nonfatal injury in 2019.

The associated costs and medical bills that result can cost thousands, if not millions of dollars. A workers’ compensation claim can become necessary to protect yourself and your family.

But how do people receive compensation for injuries? Find out what you need to know in the paragraphs below!

Definition and Services

Workers’ compensation involves providing financial and medical coverage for a work-related injury.

If approved, you can receive direct payments for lost wages, along with vocational rehabilitation. Out-of-pocket expenses related to caring for your malady are also eligible.

What Qualifies for a Claim?

The first element to understand is that your injury or illness must occur during your regular work duties.

If you were off the clock, for example, that might be a disqualifier. Otherwise, falling ill or suffering injuries due to your job in any manner may give you eligibility.

What Does Not Qualify for a Claim?

Depending on state law and your employers’ insurance carrier, the following situations may not qualify:

  • Self-inflicted physical injury
  • Mental distress
  • Violating company policy

Additionally, some states do not recognize mental injuries as fit for compensation. The best way to understand your situation is to speak to a workers’ comp lawyer.

When Should You File?

People who experience on-the-job injuries may have time limits to notify their employer. Each state can set a statute of limitations that can prevent your claim from going forward.

For example, consider the standard set by the Tennessee Department of Labor & Workforce Development for workers’ comp. This division of the state government says employees have 15 days to notify their employer of an injury.

What Happens During a Normal Approval Process?

Assuming the workers’ compensation board receives the notification of your injury on time, the process can start.

While the timeline can vary, you should hear from them or an insurance representative within a couple of weeks. After a standard waiting period, you should receive payments and instructions for your medical coverage.

In the event of a denial, you’ll receive a letter in the mail that details its justification.

What Can You Do After a Denial?

Finding a resolution after a denial may require help from a workers’ compensation lawyer. Filing an incomplete or incorrect appeal may result in an immediate rejection. So, having legal counsel by your side can literally pay off in the end.

Depending on how your case progresses, you may have a hearing with a judge or commissioner. While this isn’t a trial, it can resemble one.

Need to Know More About a Workers’ Compensation Claim?

Now that you understand the basics of a workers’ compensation claim, where should you go with questions?

You can start with contacting state authorities, but a free consultation with a lawyer can protect your rights. Choose the best path for you and continue to do whatever makes you feel more informed!

Did you find out something you needed to know about getting hurt on the job? Discover more helpful content about legal concerns on our blog.

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