When it comes to preparing for the submission of a workers’ compensation claim, it helps to know what needs to be done before submitting the claim. The workers’ compensation insurance carrier will need a number of different documents to assess the claim.
What should the client anticipate needing before going forward? We have asked lawyer, Alaina Sullivan, and here is what she had to say:
Receive Immediate Medical Attention
Before filing a claim, the injured employee needs to get immediate medical treatment for the injuries. The employee should also review his or her workers’ compensation policies to see whether the employee needs to go to a certain doctor or at least a certain practice.
If the employee is not satisfied with the opinion of this medical professional, most states will allow the employee to get a second opinion. Even if the employee does not want to get medical attention, it is important that this be done first before proceeding.
This medical record will be used as the official documentation of the injuries that happened to the employee. It is important that the employee get some medical treatment as soon as possible, however. Not receiving treatment could be seen as an admission that the injuries are not that serious to begin with.
At the same time, the employee who is injured also needs to alert his or her employer regarding the injury. This notification needs to happen within a certain statutory deadline, so it is important that the employee look to his or her given state’s guidelines to see how long he or she has to make this report.
Normally the report needs to be made pretty much immediately, and not following the guidelines can bar the employee completely from making a claim. This notification must be in writing for official record purposes.
The employer will likely have an official form for the employee to complete. If not, a form can be acquired from the state’s workers’ compensation board. This form will ask for the following information: the type of injury, the details surround when and where the accident occurred, the parties that were involved, how the accident happened, and any medical treatment that was received.
Independent Medical Examination
Once the claim paperwork has been submitted, the injured employee may have to undergo an independent medical examination (IME). An IME involves seeing a doctor who is usually chosen by the insurance company.
This doctor checks out the employee and makes a report to the insurance company. It is important that the individual come to the appointment prepared with documents and also a list of questions.
Many come into the appointment skeptical of whether the appointment will go well, especially considering the fact that the doctor is chosen by the insurance provider. Keep track of what is asked and what is done during this appointment.
Records from Missed Work
If the employee has had to miss work because of this injury, it is important that he or she keep records of this missed time to submit to the insurance provider or workers’ compensation board.
An injured employee is entitled to benefits for lost wages if he or she has missed at least seven days of work because of the work-related injury. The lost wages he or she can receive can be equal to two-thirds of the employee’s lost income.
Keep track of exactly how much time was missed as it will need to be submitted.
Records of Medical Treatment
In addition to record of missed time at work, the injured employee will also need to submit proof of medical treatment. He or she will need medical records showing that the employee cannot work or at least that the ability to work is limited because of the injuries.
Showing that the employee is regularly undergoing medical treatments and seeking medical attention will help him or her prove that the disability exists and that the employee is actively working on recovering, as much as can be done.
If the disability is more permanent, the medical treatment can still help support the claim and will need to be provided along with the workers’ compensation claim.
Contact a Lawyer Today
If you are in the process of pursuing workers’ compensation and have questions about the process and what needs to be submitted, a workers’ compensation lawyer can help review your case and discuss your options.
A lawyer can listen to the facts of the case and can best advise you on how to proceed. Contact a lawyer experienced in workers’ compensation law to schedule a consultation today.