Workers' Compensation Claim forms & denied claims
IF YOU RECEIVE PAPERWORK REGARDING A REQUEST FOR A QUALIFIED MEDICAL EVALUATION (QME) CONTACT OUR OFFICE IMMEDIATELY.
I Just Filed a Claim, What Is This Insurance Paperwork?
If you are injured on the job, it is of the utmost importance to report the injury to your employer. Prompt reporting and transparency can mean the difference between the acceptance or denial of your claim. If the injury is serious or life-threatening, seek medical attention immediately. Be sure to inform the medical staff that your injury is job-related.
You’ve filed a workers’ compensation claim with your employer and now you’re receiving letters and documents that require your review and signature from an insurance company or third party administrator.Workers’ Compensation is a specialized system that involves the understanding of medical-legal terms, so in many cases, employers or their insurance companies have retained a third party to administer the benefits associated with a work injury.
Filling Out a Workers' Compensation Claim Form
After you have been treated for your injury, you may choose to fill out a claim form. Your employer is required to give you a Workers’ Compensation claim form (DWC 1) within one working day after you report your injury or illness. Read the instructions carefully on the form and fill out the “employee” section. You will need to describe your injury in detail.
After you have made a copy of the DWC 1 form for your records, return the original form to your employer. This is called “filing the claim.” If you do so by mail, be sure to use first-class or certified mail, and request a return receipt. Within one working day, your employer must give or mail you a copy of the completed form with the “employer” section filled in. Keep this for your records.
Contact Gerald Brody & Associates for Help with Workers' Compensation Paperwork
In conclusion, it’s normal for you to receive a lot of paperwork to fill out when you file a claim. When you receive paperwork you don’t understand, we are here to help. Please give our office a call at (619) 528-9800 and in most cases, we can provide the assistance you need regarding claims paperwork over the phone. If necessary, we are more than happy to sit down and have a face-to-face consultation regarding your claim.
What If My Workers' Compensation Claim is Denied?
Although you follow proper protocol for filing a workers' compensation claim, your claim still may be denied. Common reasons for a workers' compensation claim denial include not filing on time, or the claim is disputed by an employer.
If you are having issues filing a claim, or if your claim has been denied, call us today. The professional attorneys at the Law Office of Gerald D. Brody & Associates are here to assist you and help you make sense of the complicated workers' compensation system. Give us a call at (619) 528-9800.
How Do I Notify My Employer of My Workers' Compensation Claim?
Just because your employer is aware of the injury doesn’t mean that information has been adequately forwarded to the insurance carrier or administrator. In order for the carrier or administrator to complete their review of your claim, they will likely require you to provide a medical release. Think of it this way: if you have allegedly suffered a slip and fall and sustained an injury to your lower back, you have made a claim for an orthopedic injury. Thus, the carrier/administrator needs to review your orthopedic medical history to make sure they are providing appropriate benefits. In a system where historically there has been a lot of insurance fraud, carriers scrutinize each claim.
Giving a Statement on a Workplace Injury in San Diego
You may also have to give a statement. A lot of times an employer will require you to provide an incident report. If this is not provided to the insurance carrier, they will require the facts surrounding your claim of injury. Statements can be recorded by an investigator and may be dissected by the insurance carrier to find a way to deny you benefits. If an insurance carrier wants to take your statement, it is a good idea to discuss the facts surrounding your injury with an attorney so that you know what you should and should not say to the investigator.