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May 19
How to File a Workers Comp Claim

How to File a Workers Comp Claim

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Considering that people spend a huge portion of their lives at work it should come as no surprise that workplace injuries and illnesses are among the most common of all injuries and illnesses. According to information gathered from a National Health Interview Survey (NHIS) an estimated 38% of all injuries occurred at work. This figure is even higher among men aged 55-64 for whom an estimated 49% of all injuries occurred at work. When such workplace injuries do happen, it is common for the injured person to seek workers compensation. This article will briefly discuss how to go about filing a workers comp claim and will also provide some key information about workers comp.

What Is Workers Comp and What Type of Benefits Exist?

Workers Compensation is a benefits program, typically state-run, which provides compensation for medical expenses and loss of wages incurred as a result of an accident, injury, or illness that occurred while at work. It is based on an idea called a “compensation bargain” or “exclusive remedy,” which is the concept that in exchange for giving up most of their rights to sue, employees who are injured at work will receive a package of clearly defined benefits. Another important aspect of the program is that if the employee is found to be negligent or liable for the accident he or she will not receive lesser compensation.

Types of Benefits of Workers Comp Include:

Medical Benefits – Medical benefits are designed to cover the cost of medical care that is incurred as a result of the accident or injury.

Loss of Wages – Cash benefits for loss of wages are paid if the accident or injury results in the employee being unable to work for a period of time.

Temporary Partial Disability Benefits – Temporary partial disability benefits are paid when the employee is healthy enough to return to work, but is not able to take on the full extent of their previous job duties and thus receives a smaller, partial wage. Temporary partial disability benefits are designed to compensate for that shortfall.

Permanent Total Disability Benefits – Permanent total disability benefits are paid when an employee is so severely injured that he or she is never able to return to work at all. These types of claims are rare, but very substantial when the occur.

Permanent Partial Disability – Permanent partial disability benefits are paid when an employee is permanently disabled while on the job, but not in such a way that will prevent them from returning to work. For example, loss of a limb in a job does not require use of that limb. The employee continues to receive compensation from the life-altering accident even though they can still work.

Survivor Benefits – Survivor benefits may be paid to the family of an employee who dies as the result of an accident on the job. These benefits usually include medical and funeral benefits and may also include wage replacement benefits in some cases.

Vocational Rehabilitation Benefits – Vocational rehabilitation benefits are paid when the injured employee needs special rehabilitation in order to continue working. This could include physical therapy or even training for a new job if the employee is no longer able to continue performing his or her original job.

How to File a Workers Comp Claim

It is important to receive immediate medical attention for any accident or injury suffered at work, and to document that injury accordingly. Once this has been done it is then imperative that you inform your employer of the accident as soon as possible and that you discuss filing a claim. In most cases your employer will have a workers comp claim form on hand or can easily attain one. It is then your employer’s responsibility to submit the claim form to the insurance carrier that provides the workers comp benefits.

In some cases your employer and/or the insurance company may oppose your claim. When this happens you should contact your State Workers’ Compensation Office. For Texas residents that contact information is as follows:

Division of Workers’ Compensation
7551 Metro Center Drive
Suite 100
Austin, TX 78744
Phone: 512-804-4000
FAX: 512-804-4401
Website: www.tdi.state.tx.us/wc/index.html