What do I do if my employer denies worker compensation?
14
5
Okay, let's break this down:
Since you got hurt at work and your employer is pushing back, you're in a situation where you'll likely need to formally pursue a workers' compensation claim. The fact that the incident happened two days ago means you're still well within the timeframe to initiate a claim, which is good. Your employer's actions of clocking you out and telling you it wasn't a work comp claim don't automatically make it true. They can't just decide that.
The key here is that workers' compensation is a no fault system, meaning it usually doesn't matter who was at fault for the injury. What matters is that the injury happened while you were doing something for work or during work hours. The employer's obligation to cover work related injuries is typically through their workers' compensation insurance.
Your employer saying it's not a work comp claim and making you pay for your own treatment is a significant issue. This is exactly what the workers' compensation system is designed to prevent. You had a valid injury that occurred on the job, and you also submitted a predesignation of personal physician form, which shows you were trying to follow proper procedures. This form is important because it shows you wanted to see your own doctor, which you're often entitled to do.
Even if your employer doesn't have a formal written policy they've shared with you, they are still bound by the state's workers' compensation laws. These laws typically require employers to have workers' comp insurance and to inform employees about their rights and how to file a claim. Their lack of providing you with information or a claim form is not okay.
Your next step should be to formally file a workers' compensation claim. This usually means filling out a specific claim form (often called a DWC-1 or similar, depending on the state) and sending it to your employer's workers' compensation insurance carrier. You can usually get this form from your state's workers' compensation board or commission website.
Filing this form will officially open your claim, and the insurance company will then have a certain period to either accept or deny it. If they deny it, you'll then have the right to appeal that denial, which could lead to a hearing before a workers' comp judge. Pursuing this formal process is how you can seek reimbursement for your medical expenses and any wages you lost because of your injury.
Upvote if this is a clear answer
Downvote if this is not a clear answer
Full Conversation
My employer denied me workers compensation.
I'm sorry to hear about your situation. Can you tell me more about the circumstances surrounding your workers' compensation denial?
I got an injury on the job. When I asked to see my personal physician, they clocked me out and told me it wasn’t a workers' compensation claim. I had to pay for my own treatment.
Prior to this, I turned in a predestination of personal physician form a week after getting hired.
Have you already filed a claim with your employer's workers' compensation insurance provider?
No. I was under the impression that the employer had to do so.
Is there anything else the employment lawyer should know before I connect you? Rest assured they’ll be able to help with your workers' compensation denial.
No.
Hello! My name is TJ and I’m an attorney. Thanks so much for the opportunity to assist you! I’ve gone over the details you shared and I’ll post my initial response shortly. I’ll also post a few quick questions. They’ll help me better understand your situation so I can give you a more complete and tailored answer.
VERY IMPORTANT INFORMATION:
(1) If you don’t hear back from me right away at any time throughout our conversation, please don’t worry — I WILL GET BACK TO YOU! I might be working on your response, helping another customer, or dealing with a tech issue. Depending on what’s happening, it may be several minutes (or more) between messages. That’s normal — you didn’t lose me and our conversation is not over! I’ll always respond UNLESS you ask for a second opinion (since that closes our chat). I really appreciate your patience!
(2) This is general legal info only. I can’t represent you or form an attorney-client relationship.
Hi again!
Since your employer denied your workers' compensation claim and you had to pay for your own treatment, it's important to understand your rights. Generally, it's your responsibility to file a workers' compensation claim with your employer's insurance provider, not your employer's. The fact that you submitted a predesignation of personal physician form could be helpful in your case. You'll need to formally pursue your claim to get compensation for your medical costs and lost wages.
Let's discuss this in more detail so I can provide a more thorough response.
- When exactly did your injury occur?
- What type of injury did you sustain?
- In what state is this situation occurring?
I understand.
I just want to know if I should file a complaint. The incident happened two days ago and I have since been given nothing from my employer.
Okay, let's break this down:
Since you got hurt at work and your employer is pushing back, you're in a situation where you'll likely need to formally pursue a workers' compensation claim. The fact that the incident happened two days ago means you're still well within the timeframe to initiate a claim, which is good. Your employer's actions of clocking you out and telling you it wasn't a work comp claim don't automatically make it true. They can't just decide that.
The key here is that workers' compensation is a no fault system, meaning it usually doesn't matter who was at fault for the injury. What matters is that the injury happened while you were doing something for work or during work hours. The employer's obligation to cover work related injuries is typically through their workers' compensation insurance.
Your employer saying it's not a work comp claim and making you pay for your own treatment is a significant issue. This is exactly what the workers' compensation system is designed to prevent. You had a valid injury that occurred on the job, and you also submitted a predesignation of personal physician form, which shows you were trying to follow proper procedures. This form is important because it shows you wanted to see your own doctor, which you're often entitled to do.
Even if your employer doesn't have a formal written policy they've shared with you, they are still bound by the state's workers' compensation laws. These laws typically require employers to have workers' comp insurance and to inform employees about their rights and how to file a claim. Their lack of providing you with information or a claim form is not okay.
Your next step should be to formally file a workers' compensation claim. This usually means filling out a specific claim form (often called a DWC-1 or similar, depending on the state) and sending it to your employer's workers' compensation insurance carrier. You can usually get this form from your state's workers' compensation board or commission website.
Filing this form will officially open your claim, and the insurance company will then have a certain period to either accept or deny it. If they deny it, you'll then have the right to appeal that denial, which could lead to a hearing before a workers' comp judge. Pursuing this formal process is how you can seek reimbursement for your medical expenses and any wages you lost because of your injury.
Did I completely answer your question, and do you need any clarification? Please feel free to ask any follow-up questions!
Thanks again for letting me assist you!
