How to File a Workers’ Compensation Claim

by | Jul 30, 2015 | Personal Injury

Vermont insurance laws require all employees to have workers’ compensation insurance. The policy provides benefits that cover the cost of the employee’s medical treatment. It also offers temporary wage replacement during the recovery process. However, the employee’s injuries must qualify according to the terms of the policy.

Identifying Qualifying Injuries
Workers’ Compensation covers all employee injuries that require medical attention. However, for the injury to qualify for benefits, it must prevent the worker from returning to work for an extended period. In most cases, the worker must be out of work for at least two weeks. Any injury that wouldn’t prevent the worker from performing light-duty work doesn’t qualify for these benefits.

How to File a Claim
Initially, the employer must send the worker to an emergency room or urgent care facility. The doctor performs an evaluation of the injuries and prepares a report for the insurance company. The claim’s adjuster who is assigned to the case determines if the injuries qualify for benefits.

The worker is notified by mail of these findings. If the worker is awarded benefits, they are notified of the value of these benefits and the starting date. If the worker is denied these benefits, the insurance company must provide a reason for the denial. All workers who are denied benefits have the right to file an appeal. They may also file a formal claim or lawsuit against their employer.

Filing an Appeal
To file an appeal for workers’ compensation benefits, the employee must provide evidence of a serious injury. In these cases, they are restricted to a three-year window to file the appeal or formal claim. They must provide medical evidence to support their claim. Employees who lose their job due to absences associated with the injury may also file an additional claim against their employer.

Worker’s compensation claims assist employees who were injured while performing their job duties. The insurance is a requirement for all business owners who employ more than one worker. It is used to cover the expense of work-related injuries. The benefits pay the worker a percentage of the wages while they are recovering. Workers who are denied benefits should visit website URL for additional information.

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