What Injuries Is Considered A Worker's Compensation Insurance Claim

Injuries at work may happen any time of the day, many types of injuries can access the worker’s compensation claim. To acquire the benefits of work comp, an employee injured during the scope of his work must follow certain steps to the injury. But of course, all of these steps are supervised and follow also by your employer.

The process of filing a claim for a workplace injury is a bit complicated because of the involvement of multiple parties: the employee, the employer, and the insurance provider, the healthcare provider, and the state’s worker’s comp board. This will determine if your claim will be granted or denied.

What Qualifies A Workplace Injuries

Injuries that happen or occur during the scope of the job are normally covered by worker’s compensation insurance, including accidents or illnesses dues to exposure to work activities, materials, and equipment. The employee who suffered injuries has a limited number of days to report the incident and claim the benefits. It is best to report the accidents to the employer as soon as the incident occurs. There’s a possibility of denying the claim by the insurance provider when the filing of the report is late and delay. The delaying of filing of the claim may give an impression to the provider that the report isn’t true or legitimate.

Accidents That Doesn’t Cover Work Comp

But not all workplace accidents can be granted even though the report is on time. There are some accidents a worker’s compensation limits. And here is the list of accidents that don’t cover the work comp claim.

• Stress or other psychiatric disorders.
• Self-inflicted injuries.
• Injuries caused by horseplaying or fighting.
• Injuries incurred while committing a crime.
• Injuries while under the influence of drugs or alcohol or while violating company policies.
• Cumulative events and injuries.

A condition that gives rise during too much exposure, a web designer who develops such as carpal tunnel syndrome or an employee with repeated exposure to a chemical, develops respiratory conditions. When it comes to this area the claims get a little grayer. It is best to advise you to talk to your doctor about this concern to assist you in evaluating the potential causes of your situations or conditions. This will also help you file a claim if the condition is determined to cause by your work.

Assisting your injuries by your healthcare provider will help you ensure that the claim will be granted.

How To File A Claim

To give access to the claim on work comp, an employee must:

• Notify the employer about the incident, the report should include the date, time, type of injury, and how the injury occurred.
• File a formal work comp claim.

After the report is made, the insurance provider will choose a doctor to conduct an independent medical examination. Then, the doctor will make a report that will be sent by the insurance provider, which will be used to create its compensation offer. A benefit will be granted to the employee when all of the following statements are correct and true:

• The injured worker is part of your employee workforce, not an independent contractor.
• The employer has sufficient coverage of workers comp insurance.
• And the most important is the employee is injured because of job-related activities.

These are the steps of how to file a claim with a worker’s compensation insurance. Filing a claim is not easy and has a complicated process make sure to report the incident as soon as possible to ensure the guaranteed benefits. There a lot of components and benefits of having this kind of coverage especially for small businesses.

Did you get questions about your business insurance? Call us at 208-515-2625.

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