If you suffer an injury at work, relying on sick days might be insufficient. Workers’ compensation is a crucial safety net designed to support injured employees. However, navigating its complexities, varying laws across states, and meeting specific deadlines can be challenging, impacting your entitlement to benefits.

Once you’ve reached maximum medical improvement but still can’t resume work, long-term workers’ compensation benefits may become essential to sustain you through your recovery. (Learn more on What To Do if Your Workers’ Comp Claim is Denied?)

Essential Steps To Take After a Work Injury

In the aftermath of a work injury, swift and decisive action is crucial. Report the incident promptly to your employer, ensuring all details are accurately conveyed. Seek immediate medical attention, documenting the injury, accident circumstances, and any witnesses. 

Preserve evidence and file a workers’ compensation claim with your employer or insurance. Comply with medical advice, attend follow-up appointments, and adhere to treatment plans. 

Maintain open communication with your employer, insurance, and medical providers. Understand your workers’ comp rights and seek legal guidance to navigate the process effectively if necessary. (Learn more about what to do after a work injury?)

The Workers’ Comp Process

The worker’s comp process involves the following steps: 

  • Notify your employer as soon as possible.
  • File a workers’ comp claim.
  • Get the necessary medical care until you recover.
  • Return to work once you’ve recovered.
  • Notify your employer as soon as possible:

In the event of a work-related injury, it’s crucial to promptly inform your employer about the incident. Whether it’s a sudden accident or an injury that develops over time, immediate notification ensures that your employer knows the situation and can take the necessary steps to initiate the workers’ compensation process.

  • File a workers’ comp claim:

After reporting the injury, the next step is to file a workers’ compensation claim. This involves completing the required forms, detailing the nature of the injury, how it occurred, and providing any supporting documentation. 

Filing the claim promptly is essential to initiate the process and secure the benefits you may be entitled to, including medical coverage and potential compensation for lost wages.

  • Get the necessary medical care until you recover:

Seeking timely and appropriate medical care is critical to the workers’ compensation process. Ensure you visit a healthcare provider authorized by your employer’s workers’ comp insurance. Follow the prescribed medical plan diligently, attend follow-up appointments, and adhere to any recommended treatments to support recovery.

  • Return to work once you’ve recovered:

Once you’ve sufficiently recovered and received clearance from your healthcare provider, communicate with your employer about returning to work. This may involve discussing any necessary accommodations or modifications to your duties to facilitate a smooth transition back into the workforce. 

Keeping open lines of communication with your employer is key to a successful return to work after a work-related injury. 

What Are Long-Term Workers’ Comp Benefits?

Long-term workers’ compensation benefits come into play when an individual, having reached maximum medical improvement, still faces challenges returning to their normal work activities. In such cases, the injured worker may be eligible for extended benefits to address ongoing medical needs and compensate for sustained disabilities. 

These benefits are designed to provide continued support when the employee’s recovery reaches a plateau, but the impact of the injury persists, affecting their ability to resume regular work duties.

Typically, the process for obtaining long-term workers’ comp benefits involves thorough medical evaluations, documentation of ongoing limitations, and a determination of the extent to which the injury affects the individual’s capacity to work. 

It is essential to navigate this process precisely, adhering to state-specific regulations and submitting all required documentation to secure the extended benefits necessary for sustained well-being and financial stability.

Do All Workers Qualify For Workers’ Comp?

While workers’ compensation is a widely available form of insurance that most employers must provide, not all workers qualify. The eligibility criteria can vary by jurisdiction and occupation. 

Employees who suffer work-related injuries or illnesses during their employment are eligible for workers’ compensation benefits. However, there are exceptions, and certain categories of workers, such as independent contractors or volunteers, may not be covered. 

Workers must understand the specific laws in their jurisdiction and the coverage provided by their employer to determine their eligibility for workers’ comp. (Learn more about what is worker’s comp law?)

Injuries That Qualify For Workers’ Comp

Workers’ compensation generally covers injuries or illnesses that occur while an employee performs job-related duties, regardless of fault. Whether it’s a result of a specific incident or prolonged exposure, if the injury impacts your ability to work, you may be eligible for workers’ comp benefits. 

The focus is on the connection between the injury and the job, emphasizing the circumstances under which the injury occurred and its impact on your work capacity. This makes it essential for workers to report any work-related injuries promptly and seek appropriate medical attention.

Some common injuries that qualify for workers’ comp

  • Slips, trips, and falls
  • Overexertion
  • Car accidents when working for your employer
  • Illness from exposure to chemicals or other harmful substances
  • Burns
  • Injured while working with work equipment

What Are Your Options If You Don’t Qualify For Workers’ Comp?

You may explore alternative options if you don’t qualify for workers’ comp. Personal injury lawsuits against a negligent third party, such as a product manufacturer or someone other than your employer, could be an avenue. 

You might consider applying for state disability benefits or Social Security Disability Insurance (SSDI) if your injury or illness is severe and long-term. (Learn more about What Medical Conditions Qualify For Long-Term Disability?)

What To Do If Your Workers’ Comp Claim Is Denied?

If your workers’ comp claim is denied, you should take immediate action. First, carefully review the denial letter to understand the reasons. Then, gather any missing information or evidence and consult with a workers’ comp attorney to explore your options for appealing the decision. Act promptly is crucial, as there are usually strict deadlines for filing appeals.

FAQs On Workers Comp

Workers' comp provides benefits to employees who suffer job-related injuries or illnesses. It covers medical expenses, lost wages, and rehabilitation costs. The process involves reporting the injury, filing a claim, and receiving benefits based on the severity and impact on work.
Workers' comp typically covers injuries regardless of fault, as it is a no-fault system. Even if the injury resulted from your actions, you may still be eligible for benefits. However, intentional self-harm or being under the influence of drugs/alcohol may impact eligibility.
While most workers qualify for workers' comp, independent contractors and certain types of workers may be excluded. Each state has specific criteria, so checking your eligibility is essential based on your employment status and industry.
Hiring a workers' comp lawyer is not mandatory, but it can be beneficial, especially if your claim is complex or denied. A lawyer can help navigate the legal process, gather evidence, and ensure you receive fair compensation. (Related read: When Should I Hire a Workers’ Comp Lawyer?)