Making a Claim
If you have been injured while at your job, you have a claim for workers’ compensation. Please Contact me at (503) 620-3171 or at email@example.com for a FREE CONSULTATION to learn the steps you need follow.
As soon as you know you are hurt, tell your employer about it and explain exactly what happened. Good claims have been lost because the injured worker did not carry out this number one and essential task!
Ask your employer for a Form 801 to complete. When you complete the form, state exactly what happened and the date the injury occurred. If your employer will not cooperate, write down exactly what happened on piece of paper that you label “Accident Report,” sign and date it, make a copy of it and give the original to your employer.
Your employer, or the workers’ compensation insurance carrier, must accept or deny your claim within 60-days. An acceptance or denial must be in writing. Do not rely on what the claims adjuster tells you over the phone. If you file a written claim with your employer and receive no follow-up within 60-days, contact me right away.
Once you file a claim, expect the employer’s insurance carrier to contact you. Cooperate. Answer all questions truthfully. Be honest and straight-forward. This not the time to second guess the employer or claims adjuster by hedging your answers. Do not try to out-think them.
Once you file a claim, and if you are unable to work, you will receive interim time loss benefits. This is a fancy term for lost wages. Receiving interim time loss benefits is not the same as an acceptance. Remember, an acceptance must be in writing. If your claim is denied, interim time-loss benefits will stop.
The employer may pay for some diagnostic tests while deciding what to do with your claim, but the employer is under no obligation to pay for medical services at all during this interim period.
Attend all medical appointments requested of you. But, know the doctor the claims adjuster sends you to is not there to help you. S/he is paid by the insurance carrier and his/her first loyalty is to them. So, explain exactly what happened. Answer all questions truthfully. Cooperate completely in the examination and do everything requested of you. Do not overstate or understate your symptoms. Leave the work of helping you prove your claim to your lawyer and the doctor who is your treating doctor.
Get medical attention. Do not wait. Even if you cannot afford it! You have the burden of proof to show you were hurt at work. You cannot satisfy this burden without good medical evidence showing that you work activities caused your injury. The longer you wait to see a doctor, the more difficult it is to connect your injury to your work activities. If you see a doctor, his staff should have blank 801s available for you to complete. And tell your doctor exactly how you were hurt. This is not the time to protect your employer. Telling the doctor from the very beginning what took place is just as important as telling your employer you have been hurt.
Good claims have been lost because an injured worker did not speak up soon enough or state clearly to the employer or doctor how s/he was injured. Although you might want to protect your employer and help him keep claim costs down, your number one loyalty is to you and getting the benefits you deserve. Do not fall into the trap of putting your employers’ interests ahead of your need for valuable benefits.