When you get hurt at work, there are certain deadlines that your employer and its insurance company are required to comply with, but oftentimes those deadlines are ignored. Those deadlines are as follows:
- You, the worker, has 30 days from the date of accident to notify your employer of your accident at work. If you fail to do this, that does not mean your claim will be lost by you, but you should report your claim as soon as possible.
- There is a two-year statute of limitation period. The statute is somewhat confusing and can be extended, but as a general rule you have two years from the date of accident to file an Application for Adjustment of Claim with the Workers Compensation Board.
- Your employer must file a First Report of Injury with their insurance carrier or the State Board within seven days of learning of your injury.
- The insurance company typically has 30 days from the date of the injury report to conduct their investigation and provide a written decision to either accept or deny your claim. The law also gives an extension of time of 29 additional days.
- Your first work comp check is supposed to be mailed within 15 days of the date of injury.
In reality, insurance companies oftentimes take as long as they want to investigate a claim. You have limited options to force a decision within 30 days. There is a provision under the Act to allow a request for sanctions/a monetary fine if an insurance company operates with a lack of diligence. Is the failure to investigate a claim within 30 days, a lack of diligence? Our firm thinks so.
If your claim is under investigation, your attorney may not be able to successfully get as aggressive as you'd like.
What if My Claim Is Denied?
A denied claim means the insurance company does not believe that you were hurt at work. That does not mean that your symptoms did not appear at work, but it means that your employer has taken the position that your injury was not caused by your job duties.
When this happens, the process to pursue a denied workers' comp claim can be lengthy. If your claim is denied, do not expect that your attorney will be able to get benefits for you anytime in the near future. There is a long process of discovery, a collection of medical records, a hiring of expert physicians, and waiting for a court date. This could take six months, a year, or even more.