5 Things to Consider Before Making a Workers' Compensation Claim 

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Posted: 26th April 2024 by
Lawyer Monthly
Last updated 12th July 2024
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Sustaining an injury while working can be an extremely daunting experience. It entails grappling with the injury itself, following your employer's directives on selecting a healthcare provider, facing income loss due to the injury, and other issues.

Sustaining an injury while working can be an extremely daunting experience. It entails grappling with the injury itself, following your employer's directives on selecting a healthcare provider, facing income loss due to the injury, and other issues.

The complexity increases if the injury leads to permanent disability, preventing you from returning to your usual job functions. This becomes particularly challenging when initiating a claim for workers' compensation. Here are five critical things to consider before making a workers' compensation claim.

Can You Work While Receiving Workers' Comp?

Workers' compensation benefits provide financial support when you cannot fulfil your usual work responsibilities. Nevertheless, engaging in another job or different forms of employment while your workers' compensation claim is being processed is possible.

Should you decide to return to work or take up a new job during this period, you must inform the insurance provider of your earnings, as this will lead to an adjustment in your benefits based on specific calculations. 

If your doctor gives you the green light to resume work with lighter duties, remember that such positions are available at your employer's discretion. The workers' compensation insurer typically takes the employee's word regarding these circumstances.

It falls on your employer to relay this information to the insurance company. Ensuring that the insurer receives this information from your employer is something your workers compensation lawyer should handle.

An Injured or Ill Employee May Qualify for Workers' Comp

Injuries that might be reported can range from trips or slips, ankle injuries, equipment incidents, and strains from lifting, to situations involving employees who need to travel for work purposes. Employers are urged to promptly communicate any such injuries to their insurance provider to avoid fines and ensure a swift review of the claims. 

Recognize that certain types of incidents might not fall under the scope of workers' compensation coverage. These exceptions often include deliberate self-harm by an employee, unexplained falls, or injuries sustained while the employee is engaging in a leisure activity outside of work hours.

Communicate Openly with Your Doctor

Communicating openly with your doctor when undergoing treatment for an injury sustained at work is crucial. For instance, during your initial visit, make sure you discuss the specifics of your accident and the injuries you've suffered as a consequence. Additionally, describe any pain or discomfort you experience at each appointment.

Be precise about the locations of your pain. The information you provide will be recorded by your doctor and included in your medical records. These records often play a significant role in assessing the value of your claim. Detailed medical records that consistently capture your reported symptoms can assist in securing the workers' compensation benefits you're entitled to.

Not Every Employer Provides Workers' Compensation

The necessity for workers' compensation is contingent upon each state's regulations. Variables including the employee count, business nature, and job type are influential. For example, in certain states, farmers, volunteers, or temporary workers may not be eligible for workers' comp. Businesses must review their state's legislation to determine their obligation to secure workers' compensation.

Employees Can't Sue their Employer for On-the-Job Injuries or Illnesses

Employment compensation agreements offer a balanced exchange for both employees and their employers. In this arrangement, an employee is afforded financial compensation for lost earnings and healthcare benefits, negating their ability to initiate legal action against their employer for workplace injuries under normal circumstances. Legal action becomes an option only when the employer's actions are blatantly negligent or intentionally harmful towards the employee.

Endnote

Every workers' compensation claim is unique, and the benefits offered can differ significantly. If you have experienced an injury while working, get to know the workers' comp program in your state. If anything seems amiss, don't hesitate to reach out for external help.

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