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Best practices to ensure better workers compensation claim

by | Nov 28, 2024 | Workers Compensation

An introduction to Workers Compensation

There are numerous workplace accidents happening every year and many of them are serious. That’s why worker’s compensation insurance plays important role in protecting work injury victims.

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The most common examples can be slip and fall, being hit by objects, crashes, and collisions, hazardous exposure, etc.  Because of these injuries or accidents happening at the job, workers compensation is supposed to cover all the medical costs and pay the injured for any days of work he/she miss.

Almost all employers have to have valid workers’ comp insurance. Only the active employees who accidentally injured while doing the job will be covered by workers compensation. The workers compensation insurance will also cover any sickness getting from doing the job, like being exposed to asbestos or being exposed to radiation while working.

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What should one do if they injured or got sick because of their job? Here are some best practices to follow after the work-related injury

Report the injury or illness to the Employer

Always report the injury or illness to the supervisor or the risk-management department or the HR department, shortly after it occurs. And the injured person should get an incident report to fill out.

Visit the right healthcare provider

In case the injury is an emergency, the ambulance and EMS team will take the injured to the nearest healthcare facility. In a non-emergency situation, the employer may direct the injured to a particular hospital, doctor, or clinic. It is advisable to go where the employer directs; otherwise,  the bills may not be covered by workers compensation.

Report to the doctor or hospital staffs; it is a work-related injury

When filling out the paperwork at the hospital, check the box that asks if your injury happened at work. This will help the healthcare provider to send the medical bills to the workers compensation insurance company or the employer, rather than to the injured worker.

In the event of choosing their own doctor, the injured must make sure the doctor is approved or certified to do workers compensation claims and has agreed to the workers’ comp pay schedule.

Medical records should include everything about the injury

The medical records should mention the history and mechanism of injury or illness and list every body part involved. Usually, workers compensation will not pay to treat body parts that are not listed.

Seek your employer to explain its workers’ comp coverage

It is important to know about the employer’s workers compensation program. This will most likely be available in the brochure that the employer has. Besides, the coverage information can be gathered from the state’s workers compensation office, and you can check out the information on its Web page.

Consult a Workers Comp Attorney

Workers’ comp is no-fault insurance, so the employee will be covered even when the accident is his/her fault. The percent of disability is being decided by the doctor. The doctor also decides how permanent the injury is. There are chances of being shortchanged over a permanent disability, have a complex claim, or unfairly denied coverage of medical bills.

At this juncture, the injured must need a Workers’ comp attorney at his/her side. These attorneys will analyze the medical records with the help of medical record review companies. This process will help them to understand the injuries, treatments, diagnostics, loss of wages, range of disability, and the impacts on socio-economic status. This worker’s compensation attorney will fight for the injured to get the well-deserved settlement.

Final Thoughts

Worker’s compensation insurance ensures the well-being of every employee who is covered by their employer’s worker’s comp insurance. However, the claim process must go under the scrutinization of information.  To do so, the attorneys working with medical record review companies for preparing well-documented medical record summaries. This will ultimately help them to analyze the facts and speed up the claim process. If you or your loved ones are ever injured at the workplace and your claim being denied for compensation, it is best to contact a workers’ compensation attorney.

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