In Indiana, the workers’ compensation system covers medical treatment and pays benefits to employees who are injured at work. In most cases, workers’ comp is an employee’s only method of getting compensation from his or her employer. (To learn about the exceptions, see Workplace Injury: When You Can Sue Outside of Workers’ Compensation.) Below we explain the workers’ comp system in Indiana and how to start a claim if you have been injured at work.
Nearly all private employers in Indiana are required to have workers’ compensation coverage for their employees. Most employers are insured by private insurance companies. Employers pay premiums to the insurance companies, and the insurance companies review and pay out claims. (Larger employers can also get the state’s approval to be self-insured, which means that they reviews claims and pay their employees directly.)
Workers’ compensation covers injuries that happen while you are carrying out your work duties. For example, if you are injured while operating machinery at work, you will likely be covered. Similarly, you will likely be covered if you get into a car accident while making deliveries for work. On the other hand, workers’ comp will not cover injuries that happen during your commute to and from work or that happen off-site during non-working hours.
Workers’ comp is a no-fault system, which means that employees can usually collect compensation regardless of who was at fault for the injury. However, certain injuries—such as those caused by the employee’s participation in horseplay or practical jokes—are typically not covered. (For more information, see Workers’ Compensation: Is Your Injury or Illness Work-Related?)
The first step to making a workers’ comp claim is to report your injury to your employer. Although you have 30 days to provide notice without losing your right to benefits in Indiana, it is best to tell your employer right away. The longer you wait to report your injury, the more skeptical the insurance company might be of your claim. Also, the sooner you give notice, the sooner you can begin to receive benefits.
Once you give notice of your injury, your employer should notify its insurance company and file a First Report of Injury form with the Indiana Workers’ Compensation Board. The insurance company will then investigate your claim, usually by talking to you, your employer, and your doctors. If your claim is accepted, you will begin to receive medical coverage and wage loss benefits.
Workers’ compensation should pay for all necessary medical treatment related to your work injury. This includes the cost of doctors’ visits, hospital stays, prescriptions, and medical equipment. In Indiana, your employer and its insurance company get to select your treating doctor for all non-emergency treatment. If you see your own doctor without the insurance company’s approval, it may refuse to cover your medical bills.
If the insurance company denies your claim, you can challenge its decision with the Indiana Workers’ Compensation Board. (For common grounds for a denial, see Denied Workers’ Compensation Claims.) To do so, you must file an application for adjustment of claim with the Board within two years of your injury.
Many workers can handle the initial workers’ comp claim process on their own. However, if the insurance company has denied your benefits or is disputing the amount that you are owed, you may want to consider hiring a lawyer. This is especially true if you need to attend a workers’ comp hearing, which follow complex procedural rules. For more information, see Should I Hire a Workers’ Comp Attorney or Can I Handle My Own Case?