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What Is the Worker’s Compensation Claim Process?

From the point of injury and then going forward, the first thing the person should do is immediately tell their supervisor and then give their employer a notice as soon as they realized they had been injured at work or they had acquired a work related condition.

Of course the person should seek medical attention. In case it was an emergency situation it would be better to go and seek medical attention first, then they would need to ensure they gave notice to their supervisor within thirty days from the accident. I advise my clients to give notice immediately and then get medical attention.

Our Westchester workers compensation attorneys always advise injured workers to go to an attorney early in the process, although if they were not inclined to get an attorney early, then they would still need to file the claim with the worker’s compensation board directly.

When the worker’s compensation board received the initial paperwork from the claimant, they would set up the file and tell the insurance company a claim was being made against them. The insurance company would often already know this because the employer probably would have told their insurance company about it because they would have received the notice.

In case the employer had not received the notice, then after investigating who the proper insurance carrier was, the worker’s compensation board would tell the insurance carrier that a claim was being made against them.

The insurance carrier would then be given a period of time or actually twenty-five days from the date they received notice of the claim, so that they could file their response and then either accept the claim or deny the claim.

In most cases they would accept the claim, but not make payment immediately until they received medical evidence. This means they would usually accept the claim but then not do anything about it, which is why it would be so important to get a lawyer involved early on.

In case this claim was controverted, the carrier would be required to file certain paperwork and once that paperwork was filed, the worker’s compensation board would schedule a hearing at which the dispute would be discussed and hopefully resolved.

Often times, litigation might be required where testimony from the claimant, the employer’s witnesses and the doctors might be necessary, which would be another good reason to get a lawyer.

Most cases would involve multiple hearings and they can unfortunately take longer than the involved parties would like. Our Westchester workers compensation attorneys do try to speed these cases along so that we could get a settlement as quickly as possible. I tell my clients the three main steps for them to do would be to tell their supervisor, get medical attention and get a lawyer so that the case could be filed.

The Statute Of Limitations Is Two Years

The statute of limitations would apply in the event of an accident, for instance, if the person slipped and fell at work. The statute of limitations would be two years from that accident, whereas in cases involving repetitive stress, it would be two years from when the person knew or should have known the condition was related to work or they person had become disabled.

Even if the person knew their condition was related to work but they still continued to work for many years thereafter, the statute of limitations would run until they actually stopped working and become disabled.

Why Most Claims For Workers Compensation Are Initially Denied

They would not be denied per se, and the insurance company would usually accept the case, although it would not mean that the insurance company would necessarily do anything.

Insurance companies often accept cases but then do not begin paying the claimant because they allege they had not received the proper medical reports, proper evidence or they wanted to perform more of an investigation.

A small percentage of cases are controverted initially, and those cases are set for a hearing and disposed off during the hearing process. The biggest problem that arises with worker’s compensation cases is that although they are mostly accepted, the claimant would still have to do some work to get the insurance company to respond and make payments.

Common Misunderstandings about Workers Compensation Process

The first misconception is that many clients think they have to be out of work for an extended period of time in order to receive benefits, whereas there are certainly people who have not missed any time from work whatsoever but they may still be entitled to a lump sum of cash anyway depending upon the type of injury and the severity of the injury.

Anyone who was injured at work may be eligible to receive benefits.

The other misconception is that people think they would not be able to file if the injury was their fault or if it was not the fault of their employer. The fact is, that worker’s compensation is a no fault system, so it would not actually matter whether it was their own fault, the employer’s or nobody’s fault at all, which is often the case.

The injured person would not have to prove fault to get worker’s compensation.

Another misconception is that people often think they would need to be employed for a period of time before they would be entitled to benefits. The fact is they would be entitled to worker’s compensation from the first day they started working, and they would be covered under worker’s compensation.

One of the more common misconceptions is that claimants believe they would be entitled to get paid benefits for pain and suffering that would not be covered under worker’s compensation. They would only be covered for loss of wage earning capacity and their loss of ability to work, not for pain and suffering.

For more information on Process For Filing Worker’s Compensation Cases, a free initial consultation is your next best step. Get the information and legal answers you’re seeking by calling 914-574-8330 today.

 
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