When you have a work-related injury or illness, workers' compensation may pay for your medical care, rehabilitation, some wage replacement if you have to miss work, and permanent disability benefits if you don’t recover fully. To get these benefits, you must file a claim and follow your state's procedures carefully.
Get immediate medical care if your injury requires it. Except for emergency treatment, some states require you to go to a treating doctor or medical provider network that your employer has designated.
You should inform your employer of the injury or illness as soon as possible. Typically, you have to do this within about a month in order to be eligible for benefits. But states have wildly different time limits for notifying the employer, from immediately to two years.
Your employer should give you forms to fill out. Typically, the employer will submit these forms to the insurance company, but you may have to do this in some states. In the unlikely event that your employer refuses to cooperate with you in filing a claim, a call to your local workers’ compensation office will usually remedy the situation. (You can find phone numbers for workers’ compensation officials in each state by using this map tool on the U.S. Department of Labor’s website.)
Depending on state law, you may also need to file a separate claim with your state’s workers’ compensation agency. There is a deadline for this step as well—often a year after injury. But your state may have a shorter time limit.
The insurance company will conduct an investigation before approving or denying your claim. The insurer must tell you what it decided, usually within about two to four weeks. Here again, states have different timelines.
If the claim is approved, you’ll start receiving benefits. If your claim is denied—which often happens—you have the right to appeal. This is the point when you should speak with a lawyer as soon as possible. There are many reasons for denials—from missed deadlines to disputes over whether your medical condition is related to work. The appeals process is complicated, with strict deadlines. An experienced workers’ comp attorney can help you decide whether it’s a good idea to pursue an appeal and, if so, can protect your rights throughout the process. Also, a lawyer won’t cost you anything up front. Generally, workers’ comp attorneys charge a percentage of your benefits—and don’t get anything if you lose.
To learn more details about the procedures, requirements, and deadlines for filing claims in your state, click on the state’s name below. Federal employees can find forms and instructions for filing claims here.