When you get injured on the job, Workers’ Comp should give you immediate safety-net benefits that can help you make ends meet until you get better. If you suffer a work injury, there are only a few simple, but important, rules you should follow to start your claim.
First, above all else, file your claim before the legal deadline passes. There are actually two different deadlines but only one will apply to you. For industrial injuries (injuries that happen at a specific day and time on the job), you must file your claim with the Department of Labor & Industries or your self-insured employer before the one-year anniversary of the date the injury occurred.
If your condition arose gradually and worsened over time because you repeatedly did the same work tasks, then your condition is called an “occupational disease.” Examples include contracting carpal tunnel syndrome from typing every day or suffering a lung condition from inhaling fumes over time or even getting painful arthritis in your back from repeatedly bending and lifting every day. You must file a claim for an occupational disease within two years from the date your doctor tells you, in writing, that you have an occupational disease and that you may apply for benefits. In reality, doctors rarely provide this type of written notice to you, which means the deadline might never pass. The best practice for either industrial injuries or occupational diseases is to file your claim immediately. There typically is no reason to wait!
How do you file your claim? Just tell your doctor that the injury or condition occurred on the job. If your doctor agrees there is an on-the-job injury or occupational disease, he or she must help you fill out the claim form. Most medical offices are familiar with this process and can easily help you get your claim filed. Your doctor is also required to mail the form to the Department of Labor & Industries. If your employer is self insured, then simply report your injury or condition to your employer, often at the Human Resources (HR) department, ask for an Accident Report form, fill it out, and return the completed form to the employer.
After your doctor has mailed the claim form to the Department or after you have given the claim form to your self-insured employer, simply check with the Department or employer in about a week to make sure the application was received and is being processed. This is especially important if you happen to be near the deadline for filing a claim. If your claim has been received, the Department or self-insured employer will shortly tell you whether they’ve allowed or rejected the claim.
Will I need legal help? If your claim is rejected, you should contact a workers comp lawyer right away, like those at The Walthew Law Firm. If your claim is allowed, then as long as you are receiving all appropriate benefits, in most cases you are doing just fine. If you are not sure what benefits you should be getting or if they are paid at the right amount, we will be happy to talk with you and let you know what you should be doing to keep your claim on track.
Should I do anything else to keep my claim going? After your claim has been filed, check your mailbox or email inbox every day for letters or orders from the Department. The Department has “eCorrespondence” for workers, physicians, and employers who wish to receive letters and orders from the Department electronically. When the Department wants to take official action, it must do so in writing by sending an order to the address on record.
What if I get an official order? When the Department sends you an order making an unfavorable decision on your claim, you must write a letter telling them they are wrong. Put the protest letter into the U.S. mail to the address given on the order and within the time limits provided on the order. Most Department orders have a 60-day deadline to protest. One exception is for vocational determinations (i.e., a letter denying retraining), which have a 15-day deadline. Each order or letter will tell you how much time you have to dispute it.
What do I put in my protest letter? It need not be complicated. In fact, the following is all you need: “My name is John Doe. My claim number is _____. I protest the order dated _______ because [insert the reason the order is wrong]. /s John Doe. Date”. It is helpful to enclose a copy of the disputed order. It is also helpful to explain why the order is wrong.
If you get an order you disagree with, that is a good time to call us to talk about your claim. Or, even if your claim is going okay, you are welcomed to call with questions about where your claim might be going or what certain Department actions mean for you. At The Walthew Law Firm, our group of experienced workers’ compensation lawyers are glad to answer questions about your claim so that you or your friends or family know what to expect in the future.
An article by Jon Winemiller of The Walthew Law Firm.