Filing a Claim Process for Workers’ Compensation

If you or someone you know has been injured or suffered an illness at work, then it’s best to file a Workers Compensation claim. Now, don’t be fooled about the easy steps to take when filing. There’s more to a workers’ compensation claim than you think. Workers’ compensation is a mandated system run by the government. They allow injured or disabled employees a specific type of insurance to maintain coverage to medical billing relevant to a person’s injury or illness.   There are certain situations and circumstances that can qualify as a workers’ comp claim. Depending on the state that you live in can also determine how much the Workers’ Compensation Appeals Board will refund (WCAB). Before you consider filing, take a look at how a workers’ compensation claim is processed. 

How it Works

Say you live in the state of California. Filing for a worker’s comp claim is a pretty easy process because it occurs in the matter of three easy steps! For starters, you report about your injury or illness. After that, you file an actual claim with your employer, and then all together, you file an “application for adjudication of claim”. It’s pretty simple. However, this isn’t guaranteed in other states. You have to remember that different states have different laws. So it’s best to do a little research on current statutes within your state before you file. 

Once you file the claim with your employer and WCAB, your employer’s insurance company should be prepared to authorize payment for your medical billing. There’s a wide range of insurance rates for workers’ compensation insurance. According to NASI data from 2018, records show that the average employer cost for workers’ comp in the state of Texas can start from $0.57 to $2.32 in Alaska. 

Filing with the Workers’ Compensation Appeals Board (WCAB)

The Workers’ Compensation Appeals Board (WCAB) ensures the Workers Compensation Law, which is how employees get compensated for a work-related injury. When filing a claim with the WCAB, keep in mind that the workers’ compensation appeals board can review your claim at a trial and thoroughly examine evidence within your claim about an injury. Sometimes the board can make decisions that can be unsettling and not the results you expect. With all things considered, here are a few ground rules to think about if you ever reconsider your decision in filing a workers’ comp claim. 

  • When the residing WCJ or Workers’ Compensation Judge acted beyond their power.
  • The final decision was secured through fraud 
  • Lack of evidence that was presented at your hearing
  • The evidence provided may not justify the decision 
  • If the decision is unsupported by the findings of fact. 

When to File with an Attorney 

Despite the circumstances of your injury or condition, it’s still essential to file your workers’ comp with an attorney. However, if one is excruciatingly involved in an accident where it permanently impacts your body, then that would be considered a serious case where an attorney should highly be involved. With the legal advice of an attorney, you’ll be able to determine what will be the best settlement offer. It’s also a fact that your attorney will receive an average of 25% of your settlement amount. Your legal fees should also be covered by the compensation that you receive with a workers’ comp.