How to File a Workers Compensation Claim

Filing a Claim

Getting hurt at work is a stressful event to suffer through and so is the process of applying for workers compensation benefits. A workers compensation lawyer will be able to assist the person that has suffered an injury while at work apply for their workers compensation benefits. The lawyer will need a variety of different documents when submitting an application for their client’s workers compensation benefits. Read more on the Workers Compensation Claim Checklist.

Employer’s First Report of Occupational Injury or Disease Form

The first form needed when meeting with a workers’ compensation lawyer is the employer’s first report of occupational injury or disease form. This form is basic personal information, work information, and employer information. The injured worker will need to provide their name, social security number, address, the occupation when injured, the extent of the injury, the wages they were earning at the time of the accident and much more information. This form must then be submitted to the victim’s state Department of Labor office and their insurance carrier for the claim to begin. This form should be filled out with the assistance of a workers’ compensation lawyer to make sure that all of the required information is accurate.

Notice of Accidental or Occupational Disease

This form must be filled out in order to acquire workers’ compensation benefits from an employer. Once it is filled out, the worker should present the form to their employer so that they will sign it prior to sending it to the state’s Department of Labor Workers’ Compensation Division. If the employer refuses to sign the form then the worker should submit it to the agency mentioned above along with a letter stating that the employer has refused to sign the form and that the employer doesn’t acknowledge the worker’s injury. This form is used to completely explain how the accident occurred and what the employee was doing at the time of the accident. This form also allows the employee to fill out how much money they have spent in medical coverage with either doctor visits or visits to the hospital.

Workers’ Compensation Medical Form

The workers’ compensation medical form must be filled out each time the injured worker attends a visit to their doctor. This form must be filed with the workers’ compensation insurance carrier within 10 days of the visit to a healthcare professional. Not filing this form can result in a $2,500 penalty to the injured worker and the insurer not being reimbursed. More than half of the form is to be filled out by the healthcare professional. The doctor will have to examine the worker and then report how well they have healed since the previous visit as well as document what physical improvements the worker has made.

Report of Extended Disability

If a worker’s illness or injury suffered while at work is expected to last six months or longer then the insurer of the benefits must file a report of extended disability form with their state’s Department of Labor. The nature and location of the injury on the worker must be provided on the form along with personal information of the worker that has been injured. The injury date and the disability date must also be provided on the form from the insurer.

Get Legal Help with Workers Comp

Everyone suffering from an injury that occurred at work has a tough task in front of him or her on the road to recovery. This road to recovery includes filing for workers’ compensation benefits, hiring a lawyer, filing a claim against the employer and rehabbing after the injury occurred. A lawyer will be able to fill out all of the required forms, which differ from state to state, and submit them to the proper agencies when looking for workers’ compensation benefits.


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