8 Tips for Handling Your Workers’ Comp Claim

No one looks forward to dealing with a workers’ comp claim. They can be messy and annoying, and some people will inevitably assume you’re gaming the system. But when you’re injured on the job, you can’t afford to care what others think. You need the benefits — and you also need to avoid making any painful mistakes.

We can help you take the sting out of filing your workers’ comp claim. Let’s take a look at some points you’ll need to consider as you go.

1. Seek Medical Treatment First

In an emergency situation, don’t worry about paperwork. Get help first. Even if your injury is the kind that doesn’t require treatment immediately, the quicker the better. Speedy treatment leads to a faster recovery. Be sure to document the treatment in detail, in case you have to deal with insurance hassles later.

2. Report Your Injury

Report the injury to your boss as soon as you can. In every state, you’re legally required to report the injury by a specific deadline, or you may not be able to collect worker’s comp. California’s deadline is 30 days. You’ll also need to file a claim form with the state’s Department of Industrial Relations (DIR) to receive benefits.

3. Expect More Medical Exams

Unless you waited until your employer sent you to an approved doctor, expect their insurance company to schedule another exam called an independent medical examination, or IME. The new doctor will examine your injuries, review your medical records, and file a report including their opinion of your injury, your diagnosis, any work restrictions, etc. If the IME doctor disagrees with your original exam, the insurance company may refuse or terminate your worker’s compensation benefits. IMEs are mandatory if you want to keep your benefits, and they may subject you to more than one.

4. Know Your Rights and Potential Benefits

If you’ve been injured at work in California, you can learn your rights by carefully studying the resources on the DIR website. When you make your workers’ comp claim, you may be eligible for:

  • Reimbursement for reasonable and necessary medical treatment.
  • Reimbursement for mileage incurred due to any travel related to your workers’ comp claim, including doctor visits, travel to and from IMEs, physical therapy, etc.
  • Temporary disability benefits while you’re recovering from your injury at home or in a medical facility.
  • Permanent disability benefits if your work injury caused permanent physical damage.
  • Vocational rehabilitation, including retraining for another type of job and help finding a job based on your work restrictions.

If your injuries are enough to keep you from working for a long period, expect the insurance company to challenge the extent of your injuries.

5. Go to All Appointments and Meetings

To get the benefits you need, you’ll have to follow their rules. Appear at each meeting and examination required, as well as any court date that might result from an appeal. The only exception is when you retain a lawyer to handle the claim, and even then you have to attend IMEs and some meetings yourself. If you can’t attend, let the state and insurance company know well in advance.

6. Document Everything

Keep every scrap of paper, email, or communication associated with your injury and claim, especially records of your initial medical treatment and any associated or subsequent treatment. Also hold onto:

  • Copies of your workers’ comp claim.
  • Accident reports.
  • Statements of work restrictions.
  • Any letters received from your employer or their insurance.

Take initiative on getting your own copies if you want to ensure your claim is approved.

7. You May Be Watched If You’re Awarded Long-Term Benefits

As for-profit businesses, insurance companies really, really don’t want to pay long-term benefits if they don’t have to. Almost inevitably, they’ll watch you, and may even have a detective tail you, hoping to prove you’re faking. If you think someone’s spying on you, call a workers’ comp attorney in Pasadena, CA at Dewberry Law.

8. If They Deny Your Claim, Don’t Give Up

If the state and insurance company deny benefits you really need, you have the right to an appeal. Again, it’s in your insurance company’s benefit for them not to pay out, and they often deny legitimate claims to save money.

To appeal in California, fill out an Application for Adjudication of Claim and then file the case in one of 24 offices around the state. You can get a copy of that application and a detailed discussion of the process here.

A Pasadena Workers’ Comp Lawyer Can Help With Your Worker’s Comp Claim

If your claim is complex, a Pasadena workers’ comp attorney can be invaluable in helping you navigate the bureaucracies. You’ll definitely need one if the insurance company offers a settlement, ignores you, demands more information, reduces existing benefits, or denies benefits you need. Call Dewberry Law for a free consultation.