Why Did It Take So Long for Me To Get Work Comp Benefits?
Insider Insights: What You Need to Know to Expedite Your Claim
By: Attorney Danny Vega
The question I get asked most often as a workers’ compensation attorney is: “Why did my claim take so long?”
Most people go to work every day assuming their day will be like most other days, never thinking today is the day they’ll get hurt at work. When it does happen, however, life can suddenly be flipped upside down.
Suddenly, You May Be Wondering: How Bad Am I Hurt? How Long Will I Be Out of Work? How Will I Be Able to Pay My Bills?
You go to the boss-man for answers (maybe HR), and suddenly they tell you, “Now hold on a minute, we don’t know for sure we are responsible for your injury!”
Wait a minute, you think to yourself, I thought work comp was a no-fault system? Then you think, Isn’t work comp there to help me? Are they saying I may not get workers’ compensation benefits? And it is at this moment you say to yourself, “Maybe I better hire me a lawyer!”
If you come to me with these questions, I can tell you the official answer is that when the General Assembly of South Carolina created the workers’ compensation system in 1935, they thought they were creating a system that would prevent hardship to both the injured employee and the employer. Great!
But the Next Question Then Is, “How Quickly Can We Get This Done?”
The entryway into the workers’ compensation system is a workers’ compensation “injury.” However, you must demonstrate it is an “injury by accident in the course and scope of employment.” And to the extent you may need to file a claim, you will have to demonstrate to all involved, including your employer, the insurance adjuster, and even possibly a commissioner, each and every one of the elements of that sentence.
You must demonstrate what happened was an “accident.” That there is an “injury” resulting from the accident. That you were “working” or doing “work” when you were injured. But if your employer and/or their insurance carrier believe any one of these elements is missing, you may get a denial of benefits. Which is why your employer originally said to you, “Now hold on a minute…”
How to Increase Your Chances of Receiving Workers’ Comp Benefits Quickly
While I don’t have enough space or time to explain everything necessary to help an individual with a denied claim, here are a few things you can do to ensure you have a chance of getting benefits quickly:
- First and foremost, tell your employer about the accident as soon as possible. Tell the line leader, supervisor, manager, HR, or whoever will listen as soon as you can. I can tell you from experience that people who hesitate because they think to themselves, I’ll be ok or Maybe I can sleep it off usually regret doing so. The sooner you inform your employer of the injury, the better.
- Right after telling your employer about the injury, ask to see a doctor right away. By doing so, you have already done 2 of the most important things you can do to help establish your claim. You now have documented both the accident and the injury.
- The next most important thing you can do to help yourself is document, document, document all of your activities. Keep records of your calls, texts, emails or other forms of communication. Keep copies of every piece of paper you get related to the claim from your employer, insurance company and doctor’s office. Make notes on a calendar or notebook. Keep all of this information together.
- Lastly, call an experienced workers’ compensation attorney within 10 days of the accident. You may need a few days to get well and compose yourself, but waiting a long time to file the claim will not help you.
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