How Long Does a Workers’ Compensation Claim Take?

January 3, 2024 | By DJC Law Attorneys
How Long Does a Workers’ Compensation Claim Take?

Every seven seconds, someone in the United States sustains an injury while performing their job duties, as reported by the National Safety Council (NSC). The impact of workplace accidents and illnesses can dramatically disrupt your life. What once was a routine of going to work and meeting financial needs can swiftly transform into an inability to perform job duties, stopping your paychecks.

While not every injury warrants a workers' compensation claim, some do. In valid workers' compensation cases, employees deserve to benefits from their employer to cover damages. Unfortunately, the workers' compensation claim process is often intricate and overwhelming.

Employees facing workplace injuries or illnesses deserve comprehensive medical care fully covered by workers' compensation. Compensation for lost income during time away from work is also a right. The workers' compensation system aims to alleviate these burdens, replacing the need for civil negligence cases.

Regardless of fault on the part of the employer, individuals injured on the job or diagnosed with a workplace illness have the right to compensation. Regrettably, some employees must battle for what they deserve under the law. If you find yourself in this situation, a seasoned workers' compensation attorney in Austin can provide the experience and support needed to successfully navigate the complexities of the workers' compensation process and ensure you receive the compensation you deserve.

How Long Does a Workers' Compensation Claim Take?

After filing a claim, it usually takes two to three weeks to receive your workers' compensation benefits. Depending on the type and extent of your injuries or illness, you may be legally entitled to receive compensation for your medical costs, lost income, and temporary or permanent disability if you can't work or can only work in a reduced capacity.

However, the average workers' compensation case takes about 16 months to fully resolve. The entire workers' comp settlement process can last up to 12-18 months, depending on the specifics of your claim and whether you have hired legal representation.

Hiring a qualified workers' compensation attorney will often expedite the process as the insurance company and your employer know that your attorney will call them out if they unnecessarily delay the process.

How to File a Workers' Compensation Claim

The process and timeline for filing a workers' compensation claim can differ significantly from one state to another. The U.S. Department of Labor offers resources to help individuals reach out to their respective state's workers' compensation office and initiate the filing process.

To initiate a claim, you typically need to submit a detailed report outlining the incident, your medical records, and the names of any witnesses present during the accident. Sometimes, you may have to undergo one or more independent medical examinations (IME) to evaluate the extent of your injuries.

Adherence to your state's specific requirements is crucial during this process. Failure to follow the appropriate procedures may result in the inability to collect the benefits you rightfully deserve. Instead of navigating these complexities alone, consider consulting with a workers' compensation attorney. By entrusting your case to an attorney you trust, you can focus on your physical recovery while your attorney manages everything from paperwork to meetings, negotiations, and other necessary proceedings. This ensures you navigate the workers' compensation process effectively and increases the likelihood of obtaining the necessary benefits.

Understanding the Purpose of Workers' Compensation Insurance

Given the prevalence of work-related injuries and illnesses, many states have instituted employment laws mandating the participation of employers in a state workers' compensation insurance system. This system, funded by employers, serves as a financial safety net for employees who suffer injuries on the job. Although participation in the program is not mandatory for every employer in these states, many must adhere to it.

The primary objective of workers' compensation insurance is to provide a reliable avenue for workers to obtain compensation for the financial repercussions of their work-related injuries. This insurance system plays a crucial role in preventing the inconsistent applications, outcomes, and costs associated with attempting to compensate employees through personal injury claims.

Despite the intended purpose of these programs, their administration is not always flawless. In such instances, individuals who have sustained injuries can turn to the skills and knowledge of a workers' compensation attorney. These legal professionals can navigate the complexities of the system, ensuring injured parties receive the rightful payments they deserve. By leveraging the experience of a workers' compensation attorney, individuals can better navigate the intricacies of the system and secure the financial support to which they are entitled.

Common Errors in Workers' Compensation Cases

Workers' compensation should protect injured or disabled workers, ensuring they receive the benefits they are entitled to when their work causes their injury. However, not all employers and their insurance companies act in good faith. This emphasizes the need for vigilance and understanding the common mistakes workers might make when filing workers' comp claims. Here are several common errors that injured or ill workers often commit when pursuing a workers' compensation claim.

Delaying Reporting of the Injury to the Employer

When you experience a workplace injury or receive a diagnosis for a work-related condition or illness, you must notify your employer promptly. Avoid pushing through pain or discomfort; prioritize your health and well-being. While feeling disoriented or embarrassed after a workplace injury is natural, stop all work-related activities and inform your employer immediately.

Furthermore, ensure that all communication with your employer about the injury is documented in writing. This documentation shows that you took the necessary steps to inform them about your condition.

Not Giving a Thorough and Precise Description of Your Injury

When submitting your claim and discussing your condition with your doctor, present a detailed account of how your injury occurred and the symptoms you are currently experiencing. Include essential details such as dates, locations, any pertinent prior injuries or illnesses, and the progression of symptoms. To ensure accuracy, carefully document everything you remember about the incident and any changes in physical symptoms resulting from the injury.

Avoid exaggerating or fabricating symptoms when communicating with your doctor. Even if you have a compelling case for compensation, embellishing the impact of your injury or omitting pre-existing conditions out of fear can have adverse consequences. Doctors evaluating workers' comp cases closely scrutinize for inconsistencies or signs of embellishment, comparing your current claims with your medical history.

Providing an insufficient or inaccurate account of your injury or illness may lead to the dismissal of your case, even if you would otherwise qualify for compensation.

Disregarding Your Doctor's Guidance

It's crucial to adhere to the advice of your attending physician throughout the workers' compensation claims process. Disregarding their recommendations can significantly jeopardize the legitimacy of your claim. If your doctor prescribes specific modifications or restrictions related to your work activities, ensure you provide written proof of these restrictions to your employer and follow them.

Neglecting to Hire an Experienced Workers' Compensation Attorney

In most instances, securing the representation of a workers' compensation attorney can prove immensely beneficial. These professionals serve as knowledgeable guides through the often complex legal procedures, advocate for your rights, and assist in securing the benefits rightfully owed to you. The claims process can be overwhelming and leave you feeling isolated and stressed. Insurance companies might use your limited experience to deny you the compensation you genuinely need.

A proficient and empathetic workers' compensation attorney markedly enhances your likelihood of success and offers invaluable support in navigating this intricate and challenging process.

Navigating Workers' Compensation Claims: Anticipating and Addressing Potential Challenges

Workers' compensation claims, like many insurance processes, can encounter a range of problems, both significant and minor. Being aware of potential issues and understanding how to handle them is crucial. Here are common challenges you might face during a workers' compensation injury claim:

  • Benefit Denial: The insurance carrier may unjustly deny benefits, such as disability pay, which you are legally entitled to receive.
  • Underpayment of Benefits: Even if the insurance company agrees to provide some benefits, you may not receive the full amount you are entitled to under the law.
  • Unclear Information on Medical Providers: The insurance company might offer unclear or inaccurate information about which doctors you can consult for treatment, potentially impacting the quality of your medical care.
  • Denial of Job-Relatedness: The insurance company might dispute that your injury or condition directly results from your job, leading to a complete denial of your claim.
  • Limitation on Medical Treatments: There might be attempts to restrict the type and number of medical treatments covered, affecting the adequacy of your healthcare.

These challenges can be overwhelming, but enlisting the assistance of a knowledgeable workers' compensation lawyer can make a significant difference. A seasoned attorney can protect and enforce your rights, thoroughly reviewing your entire claim to ensure you receive the maximum compensation for your injury. They can address problems promptly and efficiently, providing you with the support and guidance needed during the claims process.

In addition to seeking legal assistance, keeping detailed records of all interactions with the insurance company, documenting your medical treatment, and staying informed about workers' compensation laws in your state is advisable. This proactive approach can empower you to overcome potential challenges and ensure a smoother claims process.

Deciding on a Workers' Compensation Settlement Offer

It's rare that the initial workers' compensation settlement offer provided to an injured employee is equitable. Many individuals grappling with both physical and financial challenges may be tempted to accept this offer promptly for swift financial relief. However, when presented with a settlement offer from the workers' comp insurance company, employees can negotiate both the terms and the amount.

Typically, accepting the initial settlement offer may result in a significantly lower amount than you might achieve through negotiation. Even a single attempt to counter for a higher settlement can yield substantial differences. Initiating negotiations may prompt the insurance company to reconsider and significantly increase the payout amount.

Receiving fair compensation for medical expenses, lost income, and legal fees related to workplace injuries or illnesses is a legitimate expectation. Unfortunately, the insurance company's priority is not always aligned with ensuring fair compensation. Securing what you rightfully deserve might require negotiations, a process best navigated by experienced workers' compensation attorneys. Their skills ensure that your claim is approached strategically, maximizing the chances of achieving fair and comprehensive compensation for your situation.

Is Filing a Personal Injury Claim Possible After a Work Accident?

The workers' compensation system operates on a no-fault basis, meaning you can't hold your employer responsible for your injuries. Likewise, they generally can't attribute blame to you. Consequently, filing a personal injury legal claim against your employer is typically prohibited. However, certain circumstances exist where other parties may be liable in civil courts for workplace accidents.

While legal claims against your employer are generally not permissible, there are situations where third parties might be deemed negligent in contributing to your injury or illness. For example:

  • If a defective tool or piece of machinery caused your injuries, you can file a claim against the manufacturer of the product, especially if it's found to be defective and led to a workplace accident.
  • Suppose your accident involves a party other than your employer or coworkers, such as contract employees or companies your employer has contracted with. In that case, you may have grounds to file a claim against that party.

Consulting with a knowledgeable workers' compensation attorney as soon as possible is crucial to understanding your options. A skilled attorney can assess the circumstances surrounding your workplace injury and determine the best course of action. In some instances, you may be eligible to file a personal injury lawsuit against a third party while also pursuing workers' compensation benefits from your employer.

Dan Christensen, Personal Injury Attorney
Dan Christensen, Workers' Compensation Attorney

Suffering a workplace injury or illness can leave you in immense pain, with disabilities, and unable to pay your bills. Workers' compensation should deal with these issues. However, far too often, rightful claimants are denied benefits for invalid reasons. If you suffered an injury at work or were diagnosed with a work-related illness, it's in your best interest to meet with a Austin personal injury lawyer as soon as possible to discuss your options and rights. Remember that with the help of an attorney, your workers’ comp claim may take less time.