Step-by-step process for filing a workers’ comp claim
Workers’ compensation benefits are available for most work-related injuries in Indiana, but the benefits don’t just show up at your doorstep following your accident.
Let’s take a look at the steps you need to take to file a workers’ compensation claim in the Hoosier State, keeping in mind that failing to follow these steps could result in the denial of your claim.
Step #1: Seek medical attention
If you’ve suffered an injury or illness at work, your first priority should be your health. In order to get initial treatment, you can go to your regular primary care provider or any other doctor. However, once the claim process begins, you’ll need to see the doctor of your employer’s choosing.
Be sure to tell all medical providers that you suffered the injury at work. The medical providers should include these statements in their notes, and these notes will help support your claim down the road.
Step #2: Notify your employer
If you’re injured or become ill at work, you need to notify your employer within 30 days and insist that they prepare a written report for the workers’ compensation insurance company.
If you fail to notify your employer within 30 days of your injury, your claim might be denied. To protect yourself from this outcome, you should notify your employer’s human resource department both orally AND IN WRITING.
Be sure to send the written notification to your employer with a “return receipt requested” so that you have proof that the employer received the notice.
Step #3: Make certain your employer files the necessary form
Once you notify your employer of your injury and insist that they prepare a written report for the workers’ compensation insurance company, your employer has 7 days to fill out an Employer’s Report of Injury form and send it to the insurer (along with a copy to you).
If you don’t receive a copy of the Employer’s Report of Injury form within 7 days, you’ll need to talk to your employer to determine the problem. If your employer refuses or otherwise fails to submit the form, you should contact an attorney.
Alternatively, you can contact the Ombudsman Division of the Workers’ Compensation Board for assistance.
Step #4: Wait to receive a decision from the insurance company
Once the insurance company receives the report, the insurer must file a copy of the report with the Indiana Workers’ Compensation Board and begin its investigation of your claim.
As part of this investigation, you can expect an investigator to contact you and your employer to get the facts of the case. You can also expect that an investigator will review your social media accounts. Consequently, you shouldn’t have any information on your accounts that could be used against you (such as photos of you participating in an activity you claim you’re unable to participate in due to your injury).
Additionally, the investigator might require you to submit to an independent medical evaluation (IME) conducted by a doctor of their choosing.
The insurance company has 29 days, from the time it receives the report, to accept or deny your claim.
What workers’ compensation benefits can I receive?
If your claim is accepted, there are 3 main types of benefits you can receive:
- Medical expenses (including doctor visits, medications, physical therapy, mileage to and from the doctor)
- Wage replacement benefits (paid in weekly installments, the amount is dependent on the nature of your injury)
- Death benefits (paid to the dependents of an employee killed in a work-related accident)
What to do if your work injury claim is denied
If you’re not happy with the decision (either you were denied benefits or you weren’t awarded all the benefits you feel you deserve), you can appeal the decision.
First, talk with your employer's insurance carrier to find out why your claim was denied or why you didn’t receive the benefits you thought you should receive. Mistakes happen and sometimes disputes can be resolved by sharing information or obtaining medical records.
If you can’t resolve the dispute, contact an attorney or the Ombudsman Division of the Workers’ Compensation Board to explore alternative dispute resolution options. If these alternatives don’t help, you can file an Application for Adjustment of your Claim with the Workers’ Compensation Board. A hearing will then be set so that you can argue your case in front of a judge.
In general, an Application for Adjustment of Claim must be filed within 2 years from the date of the accident that caused the injury.
How to find an Indiana workers’ compensation attorney
A workers’ compensation attorney can help ensure that you properly file your claim. An experienced lawyer near you can also help you with your appeal if your claim is denied or if you don’t receive the benefits you think you deserve.
Workers’ compensation attorneys have experience reviewing medical records, investigating claims, negotiating with insurers, and taking insurers to court if need be.
Think you need an attorney to help with your workers’ compensation claim?
Use our free online directory to find one in your area.