What Happens After You File a Workers’ Comp Claim?

After a serious work accident, you may have immediately reported your accident to your employer. They need to know about injuries that happen at work, and they’re responsible for your Workers’ Comp benefits.

But once you file a Workers’ Comp claim, what happens? If you’re worried about the next steps in your Workers’ Comp process, a workers comp lawyer from Pathfinder Injury Law is here to help. Here’s what you can expect when you’re hurt in a work accident.

Your Insurer Will Review the Claim

The Virginia Workers’ Compensation Act requires notice to your employer within thirty days of the accident, and your claim must be on file with the Virginia Workers’ Compensation Commission within two years of your date of accident, although exceptions apply. Once you’ve done this, the insurance company is responsible for assessing your claim.

This review is meant to determine whether you were seriously injured, whether your injuries happened on the job, and what funds you’re due for the injuries you suffered.

Once the insurance company has reviewed your claim, you’ll then receive a notice about whether your claim was approved or denied.

You May Be Approved or Denied

If your claim is accepted, workers’ comp can pay for your medical treatment and part of your wages for the time you’re unable to work.

But you’re not out of options just because you were denied. Denials can happen for a number of reasons. Once you determine why your claim was denied with a Workers’ Comp lawyer, you can begin to dispute the denial.

Reasons for an initial denial often include:

• Lack of sufficient evidence regarding your injuries;
• No medical treatment after the injury; or
• Failing to provide notice to your employer within the appropriate amount of time
• An insurance adjuster just not paying attention to your claim
• Filing after the two-year deadline.

You Have a Chance to Dispute the Denial

Once you’ve determined why your Workers’ Comp claim may have been denied, you and your lawyer can then request a hearing to dispute the denial. The hearing will be held before the Virginia Workers’ Compensation Commission, and your lawyer can represent you during the proceedings.

The hearing is a chance to present new evidence and details for your claim. Because of this, it’s important to be prepared for your hearing with the evidence you need. Reach out to your lawyer for help gathering evidence before your hearing.