Workplace injuries should always be reported to the employer. Every state has different requirements, but it is best to report any workplace accident immediately (often within 30 days) and file a workers’ compensation claim as soon as possible. Missing the deadline could mean you are denied benefits.
Equally important is seeking medical attention for injuries you sustained because of the accident. To protect your health and legal rights following a work-related injury, it is important to understand exactly what happens if a workplace accident is not reported.
You Could Have Trouble Getting Compensation for Medical Treatment
If you were injured in a workplace accident, it is critical that you seek medical care. By reporting the incident to your employer, you can find out who their preferred provider is. If you receive treatment from another physician (or if you don’t get approval for your own doctor), you may end up with some or all of the bill.
As such, reporting your injury and speaking with your employer could make the difference in receiving healthcare benefits through your employer’s insurance. Keep in mind that this only applies if your injuries do not require emergency treatment. For emergency care, call 911 or go directly to the nearest emergency room or hospital.
Whether you go to the hospital, emergency room, or another doctor, you should advise them that your injury is work-related. Some states do not allow doctors to charge a patient directly when they are treating a patient for a workplace accident.
You Could Lose the Chance to Apply for Workers’ Compensation Benefits
Most states have time limits for reporting an accident to your employer, seeking medical attention, and filing a workers’ compensation claim. If you miss a deadline, you could lose workers’ compensation benefits. To ensure the best possible outcome, report your injury to your manager or supervisor as soon as possible.
Some states allow you to notify your boss of a work injury verbally, but it is in your best interests to submit the details in writing. If your employer does not have a form for work accident reporting, you can still send an email or write a letter. Be sure to include the following details:
- Date, time, and location of the accident
- How the accident occurred
- How you were injured
- Whether there were witnesses
- Any other details relating to your workplace accident
Employer Reporting Obligations Following a Workplace Accident
Once they are notified of your injury, your boss usually has a limited time to submit the claim to workers’ compensation. Your employer may also be required to report worksite incidents to the Occupational Safety and Health Administration (OSHA) and state workplace safety boards. If your employer fails to report the workplace accident to the appropriate parties, they could face fines and penalties.
Your Workers’ Comp Claim May Be Denied or Your Benefits Reduced
According to the Bureau of Labor Statistics (BLS), more than 2 million workers are injured on the job every year. Workers’ compensation exists to provide support to those who experience workplace injuries. Benefits you could pursue in a workers’ comp claim may include:
- Medical bills for your workplace injury treatments
- Lost income due to hospitalization, impairment, and doctor’s visits for your work injury treatments
- Transportation to and from medical appointments related to your work injury
- Temporary and permanent disability benefits if your work injury caused impairment
- Career rehabilitation if your work-related injury prevents you from returning to your previous job
If you do not report your workplace accident or seek medical attention in a timely manner, you could lose some or all of your workers’ compensation benefits. Not all states offer the above benefits for workers’ compensation claims. It is therefore best to speak with a workers’ compensation attorney who is familiar with the laws and regulations in your area.
Possible Exceptions for Missed Reporting Deadlines
When you do not report the injury right away, the insurance carrier may decide that the injury is not severe or disabling. You could fight a claim denial or benefit reduction, but the process can be more complicated.
There may be several reasons that you decide not to file a claim right away. In some cases, your injuries may not present until several days later. This is especially common in the case of back, neck, and head injuries. Sometimes, a workplace injury is not sudden but appears over time because of heavy lifting or repetitive stress.
Regardless of the cause, you may still have the option to file a claim outside the specified time limit. A workers’ compensation attorney can help you understand your legal rights and fight for benefits on your behalf.
Reasons Your Workers’ Compensation Claim Could Be Delayed or Denied
Sometimes, workers’ compensation claims administrators will deny your claim, even if you are eligible for workers’ comp benefits. When a claim is delayed or denied, the claims administrator will usually explain the reason for the denial or request in a letter. The specific details may differ by state, but you generally have the option to provide additional information or appeal a denied claim.
There are several reasons a workers’ compensation carrier might deny a claim, including:
- Missed reporting deadlines
- Failure to use an approved medical provider
- Insufficient proof that the injury is work-related
- Inadequate documentation for injury and treatment plan
- Treatment plan inconsistent with workers’ compensation guidelines
- Lack of documentation to prove temporary or permanent disability
- Insufficient proof of loss of work
In some cases, your injury may be deemed ineligible for workers’ compensation. Your workers’ comp lawyer can help you understand the legal alternatives, which may include filing a personal injury lawsuit against the parties responsible for your injuries.
A Workers’ Comp Lawyer Can Help You Appeal a Denied Claim
If you believe your workers’ compensation claim was unfairly denied, a workers’ compensation attorney can help. A skilled workers’ comp lawyer can investigate your claim and compile the necessary evidence to establish that:
- Your injury occurred while you were performing work duties.
- You sought medical treatment following a workplace injury.
- You reported the injury in a timely manner.
- Your injuries prevent you from working.
- Your employer did not offer alternative employment consistent with your limitations.
In the case of long-term or chronic injuries due to work stress, your attorney may also seek expert medical opinions to bolster your claim. While you take the time you need to recover from your workplace accident injury, your attorney can help you handle correspondence, emails, filings, and document requests.
Contact a Workers’ Compensation Attorney for Assistance
Whether you suffered an acute injury on the worksite or suffered long-term damage because of your work duties, you have a right to seek workers’ compensation benefits. KJT Law Group has experience handling workers’ compensation cases against large corporations and stubborn insurance companies in Los Angeles and across California. We know what it takes to pursue a successful workers’ comp claim, and we can aggressively pursue benefits on your behalf.
If you or someone you love suffered a workplace accident, contact the workers’ comp attorneys at KJT Law Group today. One of our team members will provide a free personalized consultation for your workers’ comp claim, so you can make an educated decision about your next steps.