I filed a workers’ compensation claim a couple of weeks ago, after I injured my leg at work. I haven’t been able to work since, and I haven’t heard back yet on my claim. I’m worried about how I’m going to pay my bills. How long will it take for my claim to get accepted or denied?
In most states, the timeline for a response to your workers’ compensation claim is around two to three weeks. For example, in Maine, the insurance company must accept or deny a claim within 14 days. In Pennsylvania and Arizona, the insurance company has 21 days to accept or deny a claim. Some states, however, have longer timeframes. For example, in Illinois, a worker will hear back within 28 days of filing a workers’ compensation claim.
In many states, if you don’t receive a response within a certain time, there is a presumption that your claim has been accepted. For example, in California, any claim that isn’t rejected within 90 days is presumed to be accepted. In Florida, a claim is deemed accepted if it isn’t rejected within 120 days.
The insurance company can still rebut this presumption with evidence that you are not entitled to benefits. However, it may only present evidence that wasn’t available at the time of its investigation. For example, suppose the insurance company argues that you should be denied benefits because you filed your claim late. This won’t rebut the presumption, because the insurance company would have known that you filed your claim late from the very beginning. Because it failed to deny the claim within the required time limit, your claim will probably be accepted.