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How Do I File a Workers' Compensation Claim?
Employers need to follow a few steps when filing workers' compensation claims. The process begins when an injured worker reports an incident, completes the required forms and seeks medical care.
Workers’ compensation insurance, also known as workers’ comp, is an important coverage to have because it can help your employees recover from work-related injuries or illnesses.
If one of your employee tells you they got sick or injured from their work, it’s important to file a workers’ compensation claim with your insurer right away.
1. Give Your Employee a Workers’ Comp Claim Form
If you’re told someone got hurt or sick from their job, make sure they get appropriate medical care. You’ll also want to give your employee a claim form to complete so they can apply for workers’ compensation benefits. Without a completed form, your employee can’t get workers’ compensation benefits that could help them recover and return to work.
2. Submit Official Claim Paperwork
After your employee provides a completed form, you’ll need to send it to your insurance company. This notifies your insurance carrier that a new claim is ready to be processed.
Be sure you understand how to file workers’ comp according to your state laws. Every state has a time limit to file a workers’ compensation claim. For example, Nueva York employers have to file a claim within 10 days of an accident.
3. Provide Accommodations When Your Employee Returns to Work
Depending on the injury or illness, you may need to make changes to help your employee do their job when they return to work. In some cases, you may have to train them to perform a new role.
Even if your insurance carrier decides to deny the claim, your employee can dispute their workers’ compensation benefits or file an appeal. Check your state’s claims process for workers’ compensation cases so you know what to expect.
Common Questions About the Workers’ Compensation Claims Process
With different rules by state, workers’ compensation insurance for small businesses can get complicated. We’re here to help simplify it with answers to common workers’ compensation insurance questions.
When Do I File a Workers’ Compensation Claim?
You should report injuries or illnesses if the person:
- Is your employee
- Got hurt while performing their job
- Becomes sick from their work
If you don’t file a workers’ compensation claim on time, your employee may not get benefits.
What Qualifies as a Workers’ Comp Claim?
Most work-related injuries qualify for workers’ compensation benefits. Some examples might include:
- Illness from exposure to hazardous materials in the workplace
- Broken bones from a fall on slippery office floors
- Repetitive stress injuries, such as carpal tunnel syndrome
In some cases, your employee may need urgent treatment. For non-emergencies, your insurance company may require the employee to seek medical care from an in-network provider in order to receive workers’ compensation benefits.
What Information Do I Need To File a Workers’ Compensation Claim?
When you file a workers’ compensation claim with your insurance company, you’ll need to include your:
- Account number and location code (if applicable)
- Parent company name (or program name)
- Policy number
It’s also important to send your injured worker’s information, such as their:
- Name, date of birth, address, phone number
- Social Security number
- Age and gender
- Marital status, number of dependents
- Hire date, years in current position
- Current wage information
Your claim form should include as many details of the incident as possible, such as:
- Date and time of the incident
- When you received a report of the injury or illness
- Who reported the accident and when
- Where the injury or illness occurred on your business property
- Type of injury or illness
- Exact body part injured
- Witness information
- Cause of accident
- Name and location of where your employee received medical care
- Number of days your injured worker will miss work
- Anticipated return to work date
Where Can I Find My Workers’ Comp Phone Number?
Your workers’ comp policy should include a phone number or other contact information for your insurance carrier. If you have a policy with The Hartford, you can file a workers' comp claim online. If you need help to file a workers’ compensation claim, call 800-327-3636.
How Do I Know if My Employee’s Workers’ Comp Claim Is Approved?
After you file a workers’ compensation claim, your insurance company will notify you and your employee if they approve the claim. Your employee will work with your insurance carrier to receive reimbursements for medical treatment or other benefits.
Can I Pay Workers’ Compensation Claims Out of Pocket?
If your state requires businesses to carry workers’ comp insurance and you don’t have coverage, you’re responsible for paying for your injured worker’s medical treatment and other costs they may incur. You also may face penalties and fines from your state’s workers’ compensation board.