Slip-and-fall injuries are among the most common types of workplace accidents, according to a survey by Martindale-Nolo, These accidents can occur in every type of work environment and range in severity from a roofer slipping on tiles and falling off a roof, to an office worker slipping on spilled coffee and spraining an ankle.
Unlike a personal injury lawsuit, in which you generally have to prove that another person is at fault for causing your injury, workers' comp is a "no-fault" system. This means that you can generally recover workers' comp benefits even if you were at fault for causing your own injury, as long as your injury happened while you were working. For example, if you were in a hurry at work and disregarded a "wet floor" sign, then slipped and injured yourself, you'd probably still be able to recover workers' comp benefits.
Workers' comp laws vary from state to state, but in nearly all states, the first step in a workers' comp claim is reporting your injury to your employer. Most states require that you do so within 30 days, and in some states, the reporting period is as short as three or four days.
While some slip-and-fall injuries are immediately apparent, others (such as head or soft tissue injuries) take a while to show symptoms, so it's a good idea to report a fall even if you think you're fine. A workers' comp insurer is also less likely to be skeptical of your claim if you report your injury promptly. The report should include as many details as possible about what caused the fall, the body parts that were impacted, and any pain or dizziness you feel.
In addition to reporting your injury to your employer, most states also require you to file a claim with your state workers' comp agency. Your employer typically can provide you with the forms to file your claim. Your employer is responsible for filing the claim in some states.
How long do you have to file your claim? In many states, the deadline is 12 months. But in some states, the deadline is much shorter. Check the website of your state's workers' comp agency for more details.
The insurance company conducts an investigation to determine whether to approve your claim. If your claim is approved, you'll start to receive benefits. If your claim is denied, you have the right to appeal.
Appealing a workers' comp decision can be complicated and time-consuming. It often involves several proceedings, a settlement conference or mediation, and an independent medical examination. If these efforts to resolve the claim are unsuccessful, the case will be set for a formal workers' compensation hearing.
In slip-and-fall cases, approximately 38% of employees who ultimately recover workers' comp benefits initially had their claims denied, according to a Martindale-Nolo survey. After the initial denial, 45% had to file an appeal or request a workers' comp hearing before they received a settlement or award.
A common reason given for denial of a slip-and-fall claim is a worker's preexisting condition. Insurance companies often blame back and neck injuries on the effects of aging, rather than on the workplace accident.
Because almost half of all successful workers' comp slip-and-fall claims require an appeal, an experienced lawyer can make a big difference in whether you receive a settlement or award, as well as how much compensation you receive. A workers' comp lawyer can prepare a legal analysis of your claim, negotiate for you at your settlement conference, represent you at your hearings, and make sure to comply with your state's procedural rules and deadlines.
Hiring a workers' comp lawyer won't cost you anything out of pocket. In most states, workers' comp attorneys work on a "contingency" basis, meaning they charge a percentage of your benefits if you win your case, and nothing if you lose.