Before we go into details on how to file a worker’s compensation claim, also known as workman’s comp claim or simply a comp claim, let’s first define what it is.
If an employee is injured on the job, then they are entitled to a claim, however there is a limited timeframe within which they have to submit the claim in order to receive the compensation.
When do I file the workman comp claim?
The simple answer is – ASAP.
It is best to file the claim as soon as you are injured or become sick as a consequence of your work.
If you wait for a while until you do the filing, this can put you at a disadvantage and can significantly hinder your chances to get any compensation at all.
It is important to find the laws in your state regarding workers’ compensation claims to get further details about your case.
For example an insurer for worker’s compensation can deny a payment if you have missed the deadline for the claim as they start seeing red flags the longer the time lapsed between the incident or the event that triggered the illness and the actual submission of the claim. Workers compensation attorneys are different than employment lawyers and will specialize in a different area of employment law like wage and hour claims or wrongful termination claims.
What are the conditions under which an employee can file a workman’s comp claim?
As an employee you are entitled to submit a workers’ compensation claim if your injuries were sustained on the job or within the scope of employment.
This refers to occupational accidents, trauma injuries or illness caused by exposure to work-related activities, chemicals or other dangerous substances.
In addition to file a claim the following conditions must be met:
- The employer must have a workers’ compensation policy.
- The injured party must be an employee of the business, not a contractor.
- The employee became injured while at work.
What are the employer’s duties?
The employer must follow this steps when the injury occurs:
- Provide the employee with the appropriate paperwork and guidance;
- File the claim with their insurer;
- Comply with state law requirements to report all work related injuries.
What are the employee’s duties?
When an injury occurs or a work-related illness develops, the employee must:
- Notify their employer about the injury by providing the date, time, type of injury, and how it occurred;
- File a formal workers’ comp claim with the employer.
Are there any exemptions from a workman’s comp?
Yes, there are cases that are clearly exempt form a workman’s comp which are not covered and compensation will not be paid by the insurer. Here are the most common examples:
- Stress, burnout or other mental health related injuries;
- Self-inflicted injuries;
- Injuries caused by fighting, pranks or any other form of behaviour that’s not appropriate at the workplace and is against health and safety regulations;
- Injuries that have occurred during the worker’s usual commute to or from work;
- Injuries that were sustained by the worker while committing a crime, while under the influence of drugs or alcohol, or while violating company policies.
As you can see there are many factors that have to be taken into account when filing a workman’s comp claim.
However, with the right knowledge and preparation, both employers and employees should be able to go through the process without any issues if the situation calls for it.