Home Tips 4 Tips for Understanding a Workers Compensation Claim Process

4 Tips for Understanding a Workers Compensation Claim Process

Legal proceedings aren’t always a piece of cake – especially when the reason for starting them is a certain kind of compensation caused by accidents. Lawyers know how difficult it might be to keep track of a whole bunch of details that go along with situations like this and how much effort it takes to assess the circumstances under which the incidents occur. Another aggravating circumstance for the participants of such a scenario is that it’s frequently rather tough to understand and acknowledge all those pieces of information since they’re suddenly faced with a handful of them. We can’t blame anyone for that.  The matter does seem quite complex, and at the same time the injured individual’s head seems to be in a real mess – and well, we do doubt that anyone would explore this issue unless they were subject to it, right? That explains the lack of knowledge on this topic.

Yeah, quite a sensitive topic. Everyone has the right to feel protected and safe in their workplace, but unfortunately, as we all know, that isn’t always the case. Conflicts, unstable work equipment or simply a moment of inattention might lead to short-term or long-term consequences, and it’s understandable why such incidents give policyholders every right to demand compensation. We hope that you’ll never find yourself in a similar situation – but in case that happens to you though or to someone you may know, here are some tips for better dealing with the situation and understanding it fully.

1. Keep in mind what qualifies a particular case as workers comp

Source: California Medical Evaluators

What exactly does a work injury involve? Just as its name suggests, it represents any consequence, injury, illness or death caused at a person’s workplace, or at least in some way related to it. The reasons for such consequences might be various, starting from inadequate gear which, due to its non-functionality, led to this outcome, through accidental falls and injuries unrelated to equipment, to harassment and psychological or physical violence by associates or superiors.

This includes incidents that occurred on the way from home to work and vice versa, long-term suffering of certain stressful situations that led to health deterioration or a specific disease, as well as the consequences of sudden or unexpected working conditions that adversely affected the employee’s wellbeing.

Numerous things also depend on the law of the specific state in which it happened. However, there are things that you won’t be able to attribute to this case, although they may be indirectly related to it. For example, if you yourself caused an incident under the influence of psychoactive substances or alcohol, in the case of self-harm or consciously getting into a dangerous situation that the workplace itself doesn’t prescribe.

So, to check if you qualify for this, you need to define what happened to you – where, when, in what way, whether it was within the workplace or somewhere else and similar issues. Another essential thing is studying the current laws and rules in your state and the circumstances and situations that define them.

2. Learn how the process looks like

Source: The Fox Group, LLC

Once you realize that what you’ve experienced is no doubt a work injury and once you begin worrying about the dizzying costs of treatment, medication and the amount of money you lose while out of work, it’s time to learn how to start the process. Although it seems like something too complicated, it really doesn’t have to be that way if you start following the procedure right away.

It’s recommended that the first step should be notifying the employer of the accident – and doing it as soon as possible. All legal procedures have a deadline by which you must apply or make a statement in order to receive this type of help. So, your superiors must be informed about what happened, as well as all the details related to it, in order to be able to check the circumstances under which the unfortunate event took place. Otherwise, if you wait too long, the chances of collecting compensation are drastically reduced.

Equally significant, if not even more important, is to see a doctor – immediately. Some injuries may seem minor or not so serious, but the consequences may appear later, so it isn’t advisable to wait for the pain to subside or pass. The medical documentation and report will be your proof and based on it, a decision will be made on most of the conditions under which you’ll receive the money.

Of course, apart from the fact that the employer will be there to listen and note all the details, they’ll have a legal obligation to provide their employee with all the necessary documents that need to be filled out. Also, it’s their duty to timely inform the insurer and the authorities about the unpleasant event and to respect every protocol that this situation carries.

Such a report of events in most countries includes a form, ie. a statement that the injured person fills out after receiving it from his/her superior. The insurance company needs this as a major proof and notification about what happened in order to file it as an official claim. After this, everything’s in their hands and they decide whether the request gets approved or not.

3. Understand the significance of medical checkups

Source: Dr Sindi van Zyl

Although we’ve already mentioned this, it’s worth emphasizing once again – this is by far the most significant step you can (and must) take. Insurance firms often tend to reject cases in which the injured party didn’t report the consequences of the incident in a timely manner, so it’s necessary to have everything that happened in written form. Except for compensation, this benefits your general well-being and also quicker recovery, whether it’s mental or physical health.

An excellent doctor goes without saying – don’t choose a random one, but try to ensure being examined by an expert who’ll be able to compile a relevant medical report and summarize all the injuries and the outcome of the whole situation. In most countries, you’re free to make your own choices, so this shouldn’t be a big deal. If at any time you feel that the care you’re receiving is inadequate or that the doctor’s looking more at his own benefit or cooperating with the insurance company in a way that may harm you, change them.

4. Consult with the lawyer

Source: Esgobaethbangordiocese

Whether you already have your own attorney who deals with all legal issues related to your business, but also your personal life, or you have yet to choose one, you definitely shouldn’t decide on anything or take any special steps without them. They’re there to help us get out of this situation in the most painless way possible (if it’s possible after the injury at all!) with the minimum possible damage and the maximum compensation.

Lawyers are also crucial in providing all the necessary pieces of information, clarifying dilemmas related to the procedure itself, and in this case, they represent our ‘voice of reason’.

We know that in those moments you’ll probably wonder about the additional costs that cover lawyer’s assistance, but fortunately, nowadays there’s a solution for that as well. Its name is No Win, No Fee and many law firms operate on this principle, such as Foyle Legal Lawyers from Perth, among others, especially qualified for workers compensation claims issues. This concept guarantees that your lawyer won’t charge you at all if your request is denied. That’s right, they are that confident!