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Workers Compensation Process

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Workers Compensation Process

Workers Compensation Process

  1. Plaintiff Injured on the Job: The process typically begins when a worker sustains an injury while performing their job duties.
  2. Injury Reported to Employer: The injured worker notifies their employer about the incident and the resulting injury. This step is crucial as it formally initiates the workers’ compensation claim process.
  3. Report Injury to State Commission: In many jurisdictions, after reporting the injury to the employer, it must also be reported to the state’s workers’ compensation commission or board. This step ensures that the appropriate authorities are aware of the incident and can oversee the subsequent process.
  4. Insurance Follows Up: Upon receiving notice of the injury, the employer’s insurance company follows up to gather more details about the incident and the nature of the injury. They may conduct their own investigation to assess the validity of the claim.
  5. Claim for Benefits Filed: The injured worker or their representative formally files a claim for workers’ compensation benefits with the insurance company or the state commission. This claim outlines the details of the injury, medical treatment received, and any other relevant information.
  6. 20-Day Order Issued: In some jurisdictions, after the claim is filed, a 20-day order may be issued by the state commission. This order may include instructions for both parties and sets deadlines for further actions in the process.
  7. Discovery and Hearing: Both parties engage in the discovery process where they exchange information and evidence related to the claim. This may involve gathering medical records, witness statements, and other documentation. If disputes arise that cannot be resolved through negotiation, a formal hearing may be scheduled where both sides present their arguments and evidence before an administrative law judge or panel.
  8. Award or Settlement: Following the discovery process and any hearings, the administrative law judge or panel issues a decision regarding the workers’ compensation claim. This decision may result in an award of benefits to the injured worker, or the parties may reach a settlement agreement outside of court. If the claim is successful, the injured worker receives compensation for medical expenses, lost wages, and other related damages as determined by the decision or settlement.
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