Most workers never require workers’ compensation benefits and therefore have limited information about claims. Professionals who get hurt at work or diagnosed with job-acquired medical conditions need to follow the right steps in order to secure benefits.
Complying with all program rules is crucial to securing and maintaining benefits. What does the workers’ compensation process typically involve?
Mandatory reporting to an employer
If a worker gets hurt in a traumatic incident on the job, they usually need to notify a manager or supervisor immediately. They can then make arrangements to seek medical care.
Other times, workers get diagnosed while seeing a medical professional and have to notify their employers about their condition. In such scenarios, workers typically have to make a formal report within 30 days or risk losing their eligibility for benefits. The employer needs to notify the insurance company within seven days about the injury or diagnosis.
Developing a treatment plan
In a scenario requiring emergency intervention, the worker may see a physician at a nearby hospital or urgent care facility to stabilize their condition. Typically, either the employer or the insurance company selects the health care provider in a workers’ compensation claim. That professional evaluates the worker’s symptoms and then establishes a treatment plan.
The treatment plan may include medication, physical therapy, surgery and other interventions. In some cases, the physician may recommend that the worker take a leave of absence to recover. Other times, the medical professional can provide written information about functional limitations and the accommodations the worker needs to return to work.
Managing benefits and care
A worker becomes eligible for disability benefits once they have missed seven days of employment because of their health condition. If they miss more than 21 days of work, they may ultimately be eligible for benefits covering the first week of missed work.
In some cases, there may be disagreements about the treatment that is necessary, whether the worker is ready to return to work or even the origins of their injuries. Particularly in cases involving major injuries and lengthy employment interruptions, injured workers may require the support of a legal professional.
They have the option of hiring an attorney at any point during the workers’ compensation claims process. Most employees benefit from having support from the very beginning. Workers denied benefits have the right to appeal, and those facing challenges may need to undergo specialized medical evaluations, both of which can be easier with legal support.
Learning more about workers’ compensation benefits can help people follow the necessary steps. Workers’ compensation claims can be more difficult if employees do not have the right information and support after getting hurt on the job.