First, tell your employer that you were injured. Depending on your state’s laws, you probably have to notify your employer about your injury within a certain time limit. If your employer finds out about your injury some other way (maybe your supervisor even knew about it when it happened), then you might be covered. To be safe, though, you should tell your employer as soon as you can.
After you tell your employer about the injury, you will probably have to file a formal worker’s compensation claim form with your employer, its insurance company, or even the state. Once you file that claim, you will then “enter the worker’s compensation system.” Worker’s compensation systems differ from state to state and can be very complicated. That’s why you should consider getting an attorney to help you with your worker’s compensation claim.
Proving your claim
If your employer (or, usually, your employer’s worker’s compensation insurance carrier) challenges your claim for worker’s compensation, you must prove that you have an injury and that the injury was at least partly caused by your job. To do this, you’ll probably need a doctor to support your case. If you are represented by a lawyer who specializes in worker’s compensation law, the lawyer might either send you to a doctor who has some experience in this area or speak to your doctor to make sure the doctor knows what to expect if your case goes to a hearing.
If your employer doesn’t believe you were injured on the job, he may ask you to get a second opinion from another doctor (who might be chosen by your employer). If the two doctors don’t agree, you might be able to get a third doctor to be a “tie breaker”.
Depending on your state’s workers’ compensation laws, it is possible that your state’s workers’ compensation agency will not become involved in the dispute between you and your employer until after you have appealed the case to that state agency.
Appealing a claim to the state agency
If your employer or its insurance carrier ultimately denies your claim, you probably have the right to appeal. You should file your appeal with the local state agency that handles worker’s compensation appeals. (Look for the phone number under “Worker’s Compensation” in the phone book’s “Government” section.)
Depending on your state’s laws, you probably have to appeal your claim within a certain time limit. To be on the safe side, you should appeal your claim as soon as you find out that your claim was denied.
Will there be a hearing on my appeal?
There probably will be, unless you and your employer (or its insurance company) are able to settle the claim before the hearing. Hearings differ from state to state, so you should talk to a worker’s compensation attorney if you have to go to a hearing to prove your claim.