How to Win a Workers' Comp Case

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Workers' compensation is intended to provide medical care and wage replacement to worker's who are injured or become ill as a result of their employment. Each state administers its own system so the process for filing a claim will be slightly different in each state. The basic steps required to win a workers' compensation claim, however, are the same in each state.

Things You'll Need

  • Notice of claim
  • Notice of appeal
  • Report the injury or illness to your supervisor immediately. All state workers' compensation systems require that you report the injury or illness as soon as possible and most require the injury or illness to be reported within 30 days.

  • Locate the website for the state department that oversees workers' compensation claims. The department is generally called the department or bureau of workers' compensation. Individual states administer their own workers' compensation programs so locating and understanding the exact rules for the state where you are filing your claim can make the difference between winning and losing.

  • File an official claim. Most employers will provide you with the appropriate claim forms. If they do not, then you can request one from the state department of workers' compensation. Be as specific as possible on the form and make a copy for yourself before filing it.

  • Document your injury or illness. Obtain statements from anyone that witnessed the accident or that may be able to testify about your injury or illness. Keeping a journal that includes your symptoms, treatment and level of pain may also help.

  • Seek medical treatment immediately. In many cases you will need to see a physician that is affiliated with the state workers' compensation system; however you may also have the right to an independent evaluation. Complying with treatment is important as failure to comply can result in the loss of benefits or denial of the claim.

  • Appeal a denial. If your original claim is denied, you have the right to appeal the denial. An appeal is time sensitive so make sure you file a written notice of appeal within the time limit. Your letter of denial should indicate how long you have to appeal and what the procedure is for exercising your right to appeal.

  • Prepare in advance for the appeal hearing. In most cases, your appeal will be heard by an administrative law judge at an informal hearing. Contact any witnesses ahead of time to make sure they will be able to be present. Make copies of any documentary evidence such as medical reports, bills or your journal.

Tips & Warnings

  • Request a copy of the list of physicians who accept workers' compensation patients as soon as you are injured. in the event you are not happy with the doctor your employer sends you to you will have other options.
  • There is no requirement that you hire an attorney to represent you; however, if your claim is initially denied, or your claim is complicated, hire an attorney who handles workers' compensation cases.

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