Employers purchase workers? compensation insurance to assist their employees. The coverage offers replacement for wages lost and payment for medical expenses. After an employee becomes injured on the job, the employer submits a claim on their behalf. If the injury qualifies for these benefits, the employee receives them via their chosen payment method.
How to Start an Injury Claim
All injured employees seek treatment immediately after an accident. They receive the correct forms from their human resources office. The doctor who provides their care completes this form and submits it to the insurer. The insurance company sends the documentation to a claim’s adjuster who renders a decision. If they deny the claim, the employee has the opportunity to file a formal claim through court.
What Is an Eligible Injury?
The initial requirement for an eligible injury is that it lasts longer than seven days. The second requirement is that the injury prevents them from returning to work. Injuries that allow the employee to perform light-duty qualify them for partial benefits.
The type of injury dictates how much the employee receives. Short-term injuries entitle the employee to benefits during their recovery. If the injury is permanent, the insurer provides a settlement.
Filing a Formal Claim
A formal claim includes all medical records associated with the injury. They include all documents from the insurance provider. All documentation must show how the injury occurred and that they are conclusive with the type of accident that caused it. Their work injuries attorney will present any surveillance footage captured during the accident during the hearing. When the insurer denies the benefits, the claim is filed against them.
The Official Hearing
Both parties present their case. The insurer must provide an exact reason for the denial of benefits. During the hearing, the employee’s case is represented. The judge evaluates the documentation for both sides and renders a decision. If the judge rules in favour of the insurer, the employee has the right to an appeal.
During workers? compensation cases, the employee could face financial difficulties. They could lose wages while waiting for a decision. In some cases, they may lose their job. This is why a work injuries attorney will work diligently to recover damages. To hire an attorney visit Gbmcomplaw.com today.
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