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7 Things You Must Do to Succeed with a Workers’ Compensation Claim

— January 30, 2020

Your right to seek legal advice and representation regarding your workers’ comp claim exists from the moment you suffer a work-related injury or experience symptoms from an occupational illness.

Our ethics as Columbus, Ohio-based workers’ compensation attorneys compel us to make a disclaimer up front. Nothing you do will guarantee the approval of benefits for a work-related injury or occupational illness. Too many factors influence the outcome of any single workers’ compensation claim to reveal “one weird trick”—or several—that will ensure success.

Based on our decades of experience, though, we know that no client has ever been approved to have their medical bills covered and their lost wages partially replaced unless they did most or all of the following things. Consider the first two steps listed below the two things you absolutely must do even if you skip the rest.

Do not skip the rest.

Go to the Doctor

Man with IV; image by Creators Collective, via
Man with IV; image by Creators Collective, via

Even if your company has a nurse on staff, go to the emergency room or visit your family doctor. You may need more treatment than you can receive onsite, and your symptoms may not fully emerge until hours after an accident.

Seeking medical care is also essential because the workers’ comp program and the insurance company that handles workers’ comp claims for your employer will demand extensive evidence of the cause, severity, and treatment of your injury or illness.

Meet the Deadline for Filing a Workers’ Comp Claim

This is not the second step, but it is extremely important. Our Columbus clients must file within Ohio’s one year statute of limitations unless they want the Bureau of Workers’ Compensation to reject their claim automatically. Other states set different deadlines. Missing the deadline guarantees rejection.

In almost all cases, the statute of limitations clock starts ticking on the day that the work-related injury occurred. For claims arising from occupational illnesses, the statute of limitations extends from the date on which a definitive diagnosis was made or when symptoms became so severe that continuing to work was no longer possible.

Keep Detailed Records of Medical Treatments and Physical Therapy

Save all the paperwork you receive from doctors, nurses, pharmacists, your health insurance provider, and any therapists you see while recovering and preparing to return to work. This is the medical evidence that the workers’ comp program and your employer’s insurer will demand.

Report the Injury or Illness to Your Employer

Succeeding with your workers’ comp claim requires showing that your injury or illness is work-related. Filing an accident or incident report with your employers ensures that an official investigation will be conducted. You can show the findings from that investigation to support your claim for workers’ comp benefits, or you can use the findings as starting points for additional investigation.

Be aware, too, that federal and state laws make it illegal for your employer to punish you for reporting safety issues. If you do get fired, demoted, harassed, bullied, passed over for promotion, or reassigned because you reported an accident or exposure to toxic materials, you may be able to file a lawsuit for employment retaliation.

Comply With Doctor’s Orders

Your employer’s insurance company will be monitoring your Facebook, Twitter and Instagram. Your employer may be able to access your health insurance claims. You might even find yourself being watched by private investigators when you leave your house.

None of this is against the law, and the surveillance will be done in an attempt to ‘prove’ you were not seriously injured or so sick that you had to stay away from work. Vacation photos, unfilled prescriptions, missed appointments, and even descriptions of you playing with your children can be used against you. Make sure that you are following your doctor’s recommended restrictions so that your activities won’t be used to deny compensation and treatment.

Be Prepared to Appeal a Denial of Benefits

It is difficult to estimate exactly, but a large percentage of initial applications for workers’ compensation benefits are turned down. The reason for denial could be technical and easily resolved or securing benefits may require fighting through multiple rounds of appeals and a court case. The bottom line is that you should expect pushback on your claim and that overcoming the hurdles to receiving benefits may take considerable effort.

Never Forget You Can Consult With and Hire a Lawyer Who Handles Workers’ Comp Cases

Your right to seek legal advice and representation regarding your workers’ comp claim exists from the moment you suffer a work-related injury or experience symptoms from an occupational illness. Exercising that right gives you access to the knowledge and services of someone who knows how to navigate the system and who can handle much of the paperwork while you focus on getting better and returning to your job.

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