Employee related injuries have a great impact on the business as well as the worker who was injured. The circumstances of the accident could imply that the company wasn’t following proper protocol. This could lead to OSHA violations, fines, and an increase in insurance premiums. A workers compensation lawyer in Tinton Falls helps workers who are injured fight through the red tape and get the benefits they need.
How are Claims Filed?
Initially, the claim is filed after the employee seeks medical treatment. The human resources department must give the worker a form for their doctor to complete. If the worker is unconscious, the human resources manager must ensure that the documentation is sent to the hospital.
The forms are submitted to the company’s insurance provider. They send a claim’s adjuster to acquire information from the attending doctor and the worker. This adjuster determines if the injuries are covered under the worker’s compensation insurance provided.
Are There Deadlines?
There is a ten day window in which the doctor must submit the records to the insurance provider. They must submit the forms and medical records in order for the insurer to make a decision. Equally, if the deny the claim, there is a limit of sixty days for the worker to file an appeal.
What if the Claim is Denied?
The first step after a worker’s compensation claim is denied is to determine if the worker should file an appeal. An appeal places them in front of a judge who determines if the injuries meet the requirements as outlined in the policy. The appeal is used to acquire benefits. If the injuries are extensive, the worker may need to file a formal lawsuit against their employer if they are denied these benefits. A permanent or long-term injury could produce results.
Workers who are injured while performing their job duties are covered under employer-based insurance. All employers must have worker’s compensation insurance if they hire workers for their business. The coverage pays for any medical treatment needed by the worker and replaces lost wages for the recovery period. Employees who are denied these benefits should hire a workers compensation lawyer at Kreizer Law.
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