Workers’ compensation insurance exists to provide coverage to employees in the event of an injury or illness related to their jobs. However, understanding the workers’ compensation claims process can be difficult. In addition, in some cases, the workers’ compensation insurance provider may be hesitant to approve a claim even when it’s valid.
About Workers’ Compensation
Connecticut’s workers’ compensation system provides wage replacement and medical treatment benefits to workers who become injured on the job or develop a work-related illness. The purpose of this system is to protect both workers and employers in these situations.
If you qualify for workers’ compensation benefits, you will receive benefits based on your average weekly wages in the past year. Benefits you may receive include:
- Coverage for rehabilitation expenses
- Medical treatment
- Temporary partial disability
- Temporary total disability
- Permanent partial disability
- Discretionary benefits.
The exact benefits you will receive depend on the specifics of your situation.
Most employees in the state of Connecticut are automatically covered by workers’ compensation insurance. When you are covered by this type of insurance, you are typically unable to sue your employer for any injuries or illnesses you develop because of your job.
The Workers’ Compensation Claims Process
After you are injured or fall ill on the job, you need to take action immediately. Begin by reporting your injury or illness to your employer. You should do this as soon as you become aware of the issue. Otherwise, your employer may use the delay as evidence when attempting to deny your claim.
Once you have reported the injury or illness, your employer will file a First Report of Injury Form with the Workers’ Compensation Commission and their insurance provider, and they will offer you medical treatment. Medical treatment will be provided at a company medical facility, designated physician’s office, hospital, or walk-in clinic. If your employer instructs you to receive treatment from a designated medical provider, you must accept this treatment. Your employer or your employer’s workers’ compensation insurance provider may also establish a medical care plan to provide you with treatment.
After receiving your initial treatment, you will need to file a “written notice of claim” using a 30C Form, which is available from the Workers’ Compensation Commission’s Education Services or any District Office. You should file this claim as soon as possible after you have received treatment for your injuries or illness. The statute of limitations for filing the claim is one year from the date of your injury or three years from the first symptom of an occupational disease, so make sure you have filed the form before the deadline.
Your employer’s workers’ compensation insurance carrier cannot begin sending benefit checks until they receive the First Report of Injury Form, a medical report from your physician stating that your injury is work-related and disabling, and a wage statement from your employer. Make sure all of this paperwork is submitted as soon as possible.
In some cases, your employer may decide to dispute your workers’ compensation claim. If this occurs, you will receive written notice of the denial of the claim within 28 days. If you don’t receive a denial, you should begin receiving benefits instead. If you have turned in all of the required paperwork, you have received no denial letters, and you don’t start receiving benefits within two weeks, you should contact your employer’s workers’ compensation insurance carrier to check on the status of your claim.
Dealing with Contested Claims
If your employer disputes your workers’ compensation claim, you must prove that you have a disabling injury or disease that is work-related in order to start receiving benefits. To appeal the denial, you will need to provide evidence at an informal hearing. This evidence may include medical reports, statements from witnesses, and personal statements.
Many people dealing with disputed workers’ compensation claims choose to retain an attorney. Your attorney will help you collect evidence to present at your hearing so you can maximize your chances of receiving the compensation you deserve.
Contact the Law Office of Ronald M. Scherban, P.C.
Undisputed workers’ compensation claims don’t usually require legal counsel. However, if your employer has denied your workers’ compensation claim, hiring an experienced attorney is in your best interest. To discuss a disputed claim, please contact the Law Office of Ronald M. Scherban, P.C. today.