Claiming Compensation: How to Get the Most Out of a Workers Comp Claim

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There have been more than 2.8 million work-related injuries recorded in the past year. Most of these injuries involve a workers comp claim. Not everyone will get accepted though.

Even the claims that insurance accepts, not all claims will get the compensation they deserve. This issue of compensation comes down to understanding when and how to file your claim.

Dos and Don’ts of Filing a Workers Comp Claim

In Illinois, 4,496 claims were filed in the last year. Of those filed, 2,424 were denied and 1,729 were approved. Of those approved 1,687 received their compensation.

Insurance companies look for reasons to say no or decrease your compensation. They want to make a profit, and they can’t do that if they’re paying out on claims. 

They are required to pay compensation if you can prove your claim though. This makes it important to make sure you cross every T and dot every I when filing workers comp.

Report a Workmans Comp Injury Immediately

You have a 30-day window to report your work-related injury if you want to receive benefits from workers comp. You want to report your injury to your supervisor as soon as you can.

You also need to complete all accident reports and claim reports quickly so you can complete them accurately. It’s important to give an accurate description of what happened and why.

Completing the Reports

You want to make sure you’re not impaired in any way when filing your reports. Completing forms with a clear mind ensures you don’t forget information or accidentally report inaccurate info.

Make sure info on each report filed stays consistent. Any discrepancies will cause delays or a claim denial. 

You should also make note of any witnesses to the accident. Make a list of all names so you have people available to prove your injury happened at work in case the claim is contested.

Get Medical Attention

Even if you don’t think an injury is serious, you need to get a second opinion from a doctor. Make an appointment as soon as possible after a work-related injury or get to the emergency room if the injury is serious.

Workers comp will pay for an initial visit later, but you can only prove your claim with the results of a doctor visit. Any delays in medical attention can cause the insurance company to believe the injury is less than you claim.

Sometimes the injury is related to repetitive stress from your work environment. Make sure your explanation to the doctor is clear and concise. You want their records to reflect all pertinent info for the claim.

Show Up to All Appointments

You will have many doctor and rehab appointments throughout your work injury. You must show up to everyone. If you must reschedule an appointment give a good reason, and make sure this doesn’t happen often.

If you miss too many appointments the insurance company can take this as a sign that your injury is healed or not as bad as claimed. Missed and rescheduled appointments will get noted in medical records.

Dealing with Medical Records

Make sure you tell the doctor you were injured at work during the medical visit so they can note this on their report. You will need these notes for your workers comp claim. 

The insurance company will also ask for authorization to view your medical reports before making a decision. Make sure you only give them limited authorization. There’s no need for them to see any records except those related to your injury.

Understand Available Benefits

You cannot rely on the insurance company to explain the benefits available to you. It’s their job to cut down on the amount paid out. You have to take responsibility to understand all insurance benefits and which ones you qualify for.

The most common benefits include

  • Disability
  • Medical
  • Vocational

Disability deal with payment for time lost on the job due to the injury. Medical covers medical bills. Vocational deals with new training or help finding a job if you need to change jobs due to the injury.

Disability Payments

Your disability claim will fall into two categories: temporary or permanent. Temporary disability pays for time off from work as you recover. Permanent disability compensates based on the percentage of permanent impairment due to the injury.

Medical Payments

Medical is just what it sounds, it pays for all medical bills related to your work injury. This includes initial doctor visits, rehab, and any special medical equipment needed during your recovery. You can also claim mileage if you have to travel outside a certain distance to get to appointments.

Vocational Rehab

If your injury makes it impossible for you to return to the same line of work, you can qualify for vocational rehab. This benefit pays for job training or provides help in finding a new job that fits any restrictions from your injury.

Keep Copies of All Workers Comp Records

To protect yourself, you want to make sure you have copies of all records related to your claim. Make a copy of the accident report and the insurance claim filed. Keep copies of all correspondence you receive from your employer or the insurance company.

You also want to keep copies of your medical records related to the injury, especially any work restrictions from your physician. These records will help you prove your case or contest a denial or reduction of benefits.

Hire a Lawyer

The workers comp claim is a time-consuming process. It’s also tricky to navigate if you don’t know how to protect yourself. If you’re not sure you can deal with everything involved, it might be time to hire a workers comp lawyer.

A lawyer can protect you from any shady dealings with your employer or insurance company. The lawyer can also help you determine what benefits to claim and help deal with all the red tape involved in the process.

Determine Your Next Step

If you’re dealing with a workers comp claim, and your not sure what to do, a consultation could help. Contact us for a free case review to determine how you could get more out of your insurance claim.

Get in touch with us today to get started with your FREE case review. We’re only a call, click, or short drive away.

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