How To File A Workers’ Comp Claim

August 16, 2023
Steven Schwartzapfel

Step 1: Get Medical Treatment

Your first step before filing any workers’ compensation benefits claim should be to seek immediate medical treatment. To this end, you shouldn’t bother alerting your employer or filing a claim just yet; it’s more important that you are seen by knowledgeable medical professionals.

Depending on the severity of your injury or illness, letting it develop or become worse could be a bad idea. Get medical attention and make sure you are stabilized before thinking about workers’ compensation.

Step 2: Inform Your Employer

Once you receive medical attention and are completely stabilized, you can start worrying about paying for medical services. At this stage, you should inform your employer about your injury right away.

To cover your legal bases, fill out a written report of the injuring incident and the injuries you sustained. Your employer should have a workers’ compensation claim form you can fill out. Otherwise, write down what happened on regular paper to the best of your memory and knowledge.

Don’t leave anything out, and be very specific. The details of the incident could be important if the insurance company investigates the incident and attempts to deny you workers’ comp benefits.

For more on this and related topics, call Schwartzapfel Lawyers now at 1-516-342-2200! One phone call may save you miles of headache, heartache, and financial strain down the road.

Informing Your Employer Quickly Is Vital

It is highly advisable to notify your employer of your physical stability promptly and without undue delay. For instance, if you are reasonably able to tell your employer about an injury the day after it happens, do so. The sooner you tell your employer, the better; this not only strengthens your workers’ claim but also minimizes the evidence available for the insurance company to potentially use against you.

Note: Your employer will likely file a First Report of Injury. This can happen simultaneously as you get medical care from a medical provider and reach out to a qualified workers’ compensation lawyer.

Step 3: Fill Out An Employee Claim

Now, it’s time to inform the government. Specifically, you need to fill out a C-3 Employee Claim form. You can do this online at ny.gov. Fill out as many details as you can, then submit the form. You don’t need to use any other documents to fill out the Employee Claim form, and you don’t even need to make an account with the Workers’ Compensation Board.

As a claimant of lost wages or other benefits, you need to be specific about your claim, including what body parts were injured, whether you are already on disability benefits, and other important details. Giving this information to the Department of Labor is a necessary part of the process.

What Do You Need To Know To Fill Out An Employee Claim?

To fill out the claim form effectively, an injured worker will likely need:

Your basic contact information.
Your employment information, like your employer’s name and address and your job titles and duties.
How the workplace injury happened, such as where you were and what you were doing when you were injured.
Whether you reported the injury to your employer.
The details and nature of your illness or injury, like the parts of your body that were affected and whether you have already received treatment.

What Are The Key Deadlines For Workers’ Comp Claims?

New York workers’ compensation laws are strict about how quickly employers and insurance companies must act. Some of the key deadlines in this process include:

You have (30) days to notify your employer of what occurred in writing.
You have two (2) years, starting from the date of the accident or injury, to fill out your Employee Claim, complete with your medical records and assistance from a law firm.
Within (48) hours of treating you for an accident, your doctor has to complete a Doctor’s Initial Report or Form C-4, then mail that to the appropriate District Office, your employer, your employer’s insurance company, and you, the injured employee. If they don’t, your doctor could be found liable for a medical malpractice suit.
Your employer has to report an injury to the Workers’ Compensation Board of New York within (10) days of being notified of the accident.
Your insurance carrier has to give you a written statement of your rights by the law within (14) days of receiving the Employer’s Report.
Your insurance carrier must begin paying your benefits within (18) days of receiving the Employer’s Report if the claim hasn’t been approved or denied within seven (7) days. In this way, you can start receiving comp insurance by completing the claims process even if your claim hasn’t fully been approved by the insurance company quite yet. You can use that money to pay for medical expenses, cover expenses for your dependents, etc.

In other words, you should start seeing benefits from your workers’ compensation claim within a little more than two (2) weeks at most.

If you believe your NYS employer or the workers’ compensation insurance company isn’t sticking to this timeline, please contact Schwartzapfel Lawyers right away. Our knowledgeable attorneys can help you at any stage of the workers’ comp payment process when you call 1-516-342-2200 or visit us online today!

Step 4: Check With Your Employer

Once you submit your Employee Claim form, you should check in with your employer about a week later. Remember, you have two (2) years from the date of your injury to do so. Still, sooner is usually better than later in these situations. The two-year deadline is intended to protect employees who are injured and whose symptoms may not appear for several months or years after the incident.

Your employer should have already submitted an Employer’s Report of Work-Related Injury/Illness, otherwise known as Form C-2. If they haven’t done this, request that they do so immediately. Note: The sooner they do it, the sooner you can receive your benefits.

Step 5: Receive Your Payments

If all goes as planned, you’ll receive your workers’ benefits in no time. Depending on the circumstances of your illness or injury, you may receive a lump sum payment to help you cover immediate medical bills, or you may receive ongoing benefits and payments so you can continue to pay for medical treatment and recovery expenses.

What Happens If Your Claim Is Denied?

In a perfect world, every workers’ comp claim would be accepted. Unfortunately, many workers find other benefits claims are denied by the insurance company behind their employers.

This can happen for many different reasons, such as:

The insurance company doesn’t believe you were on workplace premises or in the performance of work-related duties when you were injured.
The insurance company has some reason to doubt your claim or the symptoms of your injuries.
The insurance company is trying to save money.

Regardless of the reasons behind this activity, you need to know what to do so you can get the benefits you require to stabilize your finances.

In these circumstances, you’re best off speaking to knowledgeable workers’ compensation attorneys like Schwartzapfel Lawyers. The right workers’ comp attorneys can immediately bolster your case by providing you with such legal services as:

Gathering evidence to substantiate your claim about a work injury if the insurance company requires more evidence. This can include security camera footage, eyewitness accounts, and more.
Negotiating with the insurance companies. In some cases, you may simply have not filled out the right form properly. Your lawyer can speak to the insurance company and clear up any miscommunications.
Helping you fill out your Employee Claim form properly the first time. This can actually be invaluable, as it will likely minimize the likelihood of you encountering any difficulties or delays in recovering your opposition benefits.
Providing you with legal counsel. If you are forced to sue the insurance company, you’ll only want to do so with a skilled attorney on your side.

Your financial future is too important. Don’t wait. If you believe you or a loved one needs legal assistance, please call 1-516-342-2200 or schedule a free consultation online now!

Contact Schwartzapfel Lawyers Today

Now you know how to file a workers’ comp claim and begin the process of recovering monetary compensation for your on-the-job injuries. By performing the steps we’ve outlined, you may well alleviate the financial strain you’ve experienced since being injured at or because of your work.

Still, if you or a loved one is having trouble with the process, or if you have additional questions, please don’t discount the value of knowledgeable legal representation. Schwartzapfel Lawyers’ experienced attorneys can provide sound legal counsel and help you through the workers’ comp filing process, as well as negotiate with insurance companies if need be.

Simply dial 1-516-342-2200 or visit us online to schedule your free consultation and/or case evaluation today. It will be our honor and privilege to fight for you every step of the way!

DISCLAIMER: Nothing on this page should be considered legal advice. You should seek the appropriate counsel your situation requires. For more information, call 1-516-342-2200 now!

Sources:

Schwartzapfel Lawyers, P.C. | Fighting For You™™

Workers’ Compensation | U.S. Department of Labor

State of New York | Workers’ Compensation Board

NYS WCB Contact Information | Workers’ Compensation Board

Health Care Providers Workers’ Compensation Forms | Workers’ Compensation Board

Workers’ Compensation Insurance | Workers’ Compensation Board

Workers’ Compensation Program | U.S. Department of the Interior