How to File a Workers’ Compensation Claim

Topics: Workers' Compensation

As an industry leader in workers’ compensation coverage, we discuss it quite a bit here on PolicyWire. And as a small business owner, you might be familiar with workers’ comp coverage and how it works. But if you’ve never been through the workers’ compensation claim process, you might not know what you’re in for. Let’s take a closer look at what happens when you file a workers’ comp claim.

How to File a Workers’ Comp Claim in 5 Steps

employer filing a workers' compensation claim


Step 1: The employee reports an injury to the employer

A work-related injury occurs to an employee and he or she reports the injury to the employer (this needs to be done within a certain period of time, depending upon the state’s laws – usually 30-90 days). The employee should seek medical attention right away for a serious or life-threatening injury. If it is a non-emergency, the employee should visit a medical provider designated by the employer.

Step 2: The employer files the claim with their insurance carrier

Upon receipt of the work injury, a supervisor (or HR representative) should provide the necessary paperwork to the employee, and report the injury to the company’s workers’ comp insurance provider.

Step 3: The insurer will either approve or deny the claim

The workers’ compensation insurance carrier will determine whether a claim is approved or denied based on the circumstances around the injury. If it is approved, the employee can accept the payment offered to cover items like medical bills and lost wages, or they can negotiate for a lump-sum settlement. If the claim is denied, the employee can appeal the decision.

Step 4: Continue receiving medical treatment and monitor the status of your claim

The employee continues receiving treatment and may follow up on the status of their claim periodically.

Step 5: The employee returns to work or appeals their denied claim

Once the injured employee is healthy enough, he or she will return to work (either full-time or in a limited role) unless the injury leaves them totally disabled. If the claim is denied, the injured employee may see professional legal help to appeal the decision.

AmTrust for Small Business Workers’ Compensation Coverage

AmTrust is a leader in workers’ compensation insurance for small to mid-sized businesses. Reach out to your insurance agent or contact us today to find out how we can design specific insurance packages to fit your needs.

This material is for informational purposes only and is not legal or business advice. Neither AmTrust Financial Services, Inc. nor any of its subsidiaries or affiliates represents or warrants that the information contained herein is appropriate or suitable for any specific business or legal purpose. Readers seeking resolution of specific questions should consult their business and/or legal advisors. Coverages may vary by location. Contact your local RSM for more information.

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