Workers Compensation

How to File a Workers' Compensation Claim

By Serena Lipski, ​J.D., University of Toledo College of Law
Each state has procedural rules that you must follow in order to collect benefits.

If you’ve been injured on the job, you most likely are entitled to workers’ compensation benefits. Workers’ comp covers the cost of your medical bills, provides benefits during your time off work, and compensates you for any lasting impairment caused by your injuries.

However, to be eligible for workers’ comp benefits, you must follow certain rules. This article explains how to get medical treatment, how to report your injury to your employer, and how to file a claim for benefits.

Seeking Medical Treatment

You should get medical treatment as soon as possible after your accident. A delay in treatment will make your claim for benefits seem less credible. The insurance company may assume that your injury wasn’t that serious—or didn’t happen at all—if you didn’t seek treatment right away.

If you need emergency care, you can go to the nearest hospital or doctor. However, for non-emergency care, you will need to follow your state’s rules for choosing a treating doctor. Some states, such as Florida, allow your employer (or its insurance company) to select your treating doctor in most cases. In other states, such as Ohio, you have the right to choose your own treating doctor. And in other states, like Texas, you must choose a doctor from an approved list of providers, if your employer has established a health care network for work-related injuries. (For more information, see How to Get Treatment for a Work-Related Injury.)

Reporting Your Injury

In most states, you will need to report your injury to your employer within a relatively short time frame. While some states require workers to give notice immediately or as soon as possible, other states have slightly longer time frames. For example, workers must give notice within 30 days in California and within 45 days in Illinois. If they miss the deadline, they may lose out on benefits.

In general, though, the best practice is to notify your supervisor or your human resources department of your injury as soon as possible. When notifying your employer, you should explain that you have suffered a work-related injury, that you are seeking treatment for your injury, and whether you will need time off from work. It’s usually best to give notice in writing; some states, including New York, require written notice.

Some employers will ask you to fill out a written accident report documenting how your injury occurred. The form usually requests information about the time, date, and place of the injury, the nature of your injury, what you were doing at the time of the injury, whether there were any witnesses, and what treatment you are receiving. Because this form could later be used as evidence in your claim, you should do your best to be as accurate as possible. If you don’t know the answer or can’t remember something, don’t be afraid to state that on the form or leave certain questions blank.

Your employer will likely ask you to provide a doctor’s note to verify your need for time off from work. Make sure to request off-work slips from your doctor periodically.

Obtaining Workers’ Comp Benefits

In most states, employers have private insurance to pay workers’ compensation claims. In these states, once you have informed your employer that your injury is work-related, your employer will notify its insurance company of your claim for benefits. The insurance company will then determine whether you are entitled to benefits. This decision usually must be made within a few weeks after you notify your employer of your injury. For example, in California, the insurance company has 14 days to decide; in New York, the time limit is 18 days.

At the end of this time frame, the insurance company will typically either accept your claim and begin payment, or it will notify you in writing of its decision to deny benefits. If the insurance company decides not to pay benefits, you can file a claim for benefits with the state workers’ compensation agency to dispute the insurance company’s decision.

In many states, you don't need to file an official workers’ comp claim unless you are disputing a denial of benefits. However, in some states, such as Texas, you will need to file a claim with your state agency at the beginning of the process in order to protect your claim. Most state agencies have standard forms for filing a claim for benefits.

All states impose strict time limits for when your claim must be filed, typically between one and three years from the date of your injury or from the date you realized you had a work-related occupational disease. For example, in New York, you must file a claim form with the Workers’ Compensation Board within two years of the date of your accident or of the date that you knew or should have known that you developed an occupational disease due to your job. In Texas, you have only one year to file your claim.

When to Contact a Lawyer

While many workers contact a lawyer shortly after they are injured, others try to handle their claims themselves. If your injuries are minor and the insurance company isn’t disputing your claim, you may be able to handle your claim on your own. However, if your injuries are moderate to severe, or the insurance company is disputing your claim, you should contact a lawyer to make sure that you get the maximum benefits possible. (For more information, see Will a Workers' Comp Lawyer Get Me More in Benefits?)

You can also fill out our free case evaluation to find an experienced workers’ compensation attorney in your area.
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