5 Steps To Take When Faced with a Workers Compensation Claim

When an employee is injured while at work, and this could result in a workers compensation claim, as a responsible employer there are several steps you’ll need to take to protect yourself and your employee. According to a leading Nevada workers compensation attorney, unless you have experience in this field it’s always wise to consult a legal specialist who’ll help you to navigate the procedure and ensure you’re complying with all your obligations, but may also assist in more complicated cases.

To avoid severe penalties, it’s essential to follow the correct procedure and avoid falling foul of workers’ compensation laws, which vary from state to state. In the event an employee sustains an injury while at work, here are the most important, starting from the moment the injury occurs.

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Seek medical care

The employee must seek immediate medical care – even if a trip to the emergency room isn’t required, an assessment by a primary care provider and referral to a specialist will be essential to obtain all relevant medical documentation.

The employee makes the claim

The employee must inform you of their decision to claim by completing a Notice of Injury form (unless medical circumstances prevent this). The deadline for this varies – in New York, it’s 30 days, while in Nevada it’s 7 days, and others states allow up to one or even 2 years.

After this, the employee has 90 days to file a claim with your insurer. If the employee has died as a result of the incident, their dependents or their representatives have one year to file a claim.

Provide the necessary paperwork

As soon as you’re informed of the injury, you have to provide the employee with all the necessary documentation. Again, this varies from state to state, but typically includes the forms needed to report to your workers’ comp insurance provider and the state workers comp board. You should also provide them with information about their rights and benefits. Finally, you’ll need to let them know about their return-to-work procedure.

Submit the claim

Typically, as the employer, you’ll submit the claim to the insurer and the state workers comp board. The insurer will review and then accept or reject it.

What happens next is between the insurer, the employee, and their medical providers. The employee can accept the offer, or try and negotiate a larger sum. If their claim is rejected, ask for a review and appeal. In either case, the insurer will notify the state workers comp board of the outcome.

The employee returns to work

Immediately after the injury, any hazards that have caused it should have been removed and the workplace made safe. Additional training may be required, or safety notices posted to prevent others from being injured similarly.

When the employee returns to work ensure a plan is in place and make any adjustments to the workspace, schedule, or duties that may be required.

If your insurer continues to receive claims for injury compensation, expect to see a steep rise in your premiums. Better for all concerned to ensure that your workplace is incident-free.

FG Editorial Team
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