Making a Workers Comp Claim

If a worker receives a workplace injury, as part of making a workers comp claim the injured employee (or a representative) must report the injury to their employer. A worker generally is not entitled to compensation unless notice of the injury was given to the employer within thirty ( 30) days of the accident or thirty (30 )days when the worker knows that his/her injury is work related.. If medical attention was required to treat the injury, then the employee must provide certain medical information to their employer as well. In most cases the injured worker will need to file a written workers compensation Notice of Injury form.

The Claims Process

After receiving a report of injury,, the employer within seven ( 7) days must then report the injury to its insurance carrier. The insurer must then send the employee within three(3) days an informational brochure explaining your rights, benefits, procedures for obtaining benefits and obligations under the workers comp law.

After a claim is submitted, the insurance company has the option and will decide whether or not to accept the claim. The determination of payment of benefits will not happen automatically; first the insurer will obtain the facts of the injury by questioning the injured worker, the employer, and the doctor who has examined and treated the worker.

Within fourteen (14) calender days of being informed of the accident/injury, the insurer must pay wage replacement benefits when disability is immediate and continuous for eight (8) or more days. The insurer must also authorize, provide and pay for appropriate medical care and treatment for aninjured worker. Generally, the insurer gets to pick the doctor who treats an injured worker.

If the insurer fails or refuses to pay you wage benefits, provide medical care or cover a specific injury, you have the right to file a formal written Petition for Benefits claiming such benefits with the State.  Filing a written Petition for Benefits invokes the jurisdiction of the Judge of Compensation Claims who will conduct a trial to decide whether you are entitled to the benefits you claim are owed to you.

To learn more about filing a workers compensation claim in West Palm Beach and the surrounding areas in Florida, call the law firm of Attorney Louis P. Pfeffer today toll-free at 866-959-9237or fill out our online form.