What Happens When You File a Workers’ Compensation Claim?

When you suffer a work-related injury or illness, it can be confusing to understand what happens next. The workers’ compensation process allows injured employees to get medical treatment and wage replacement while they recover. Knowing what happens when you file a workers’ compensation claim helps you protect your rights and make sure you receive the benefits you deserve.

Davidoff Law helps every injured worker understand their rights under workers’ compensation insurance. Our legal team guides you through every step of the claims process, from filing paperwork to dealing with the insurance company.

We explain how to handle medical care, gather supporting documentation, and communicate with your employer or the insurance carrier. Our Queens personal injury lawyer helps injured employees file their workers’ comp claims correctly and get the benefits they are entitled to under New York law.

Step 1: Report Your Injury to Your Employer

Reporting your injury right away is the most important step in the workers’ compensation claims process. If you wait too long, your claim might be denied. Always report any injury, even if it seems minor, since some workplace injuries can worsen over time.

Notify Your Employer Immediately

Tell your supervisor as soon as the injury occurs. Most states, including New York, require that an employee report a work-related injury or illness as soon as possible. Quick employer notification helps start the claim submission and allows you to get immediate medical attention if needed.

Provide Written Notice

You must also give a written report describing how the injury or illness happened. Include when, where, and how it occurred. Keep a copy for your records in case the employer or insurance carrier questions your report later. Clear and complete written notice supports your workers’ compensation insurance claim and helps prevent disputes.

Step 2: Your Employer Files a First Report of Injury

After you report the incident, your employer must file an official report with the workers’ compensation board. This document starts the workers’ comp claims process and alerts the insurance carrier to your employee’s injury.

Employer’s Responsibility

Your employer is responsible for notifying their workers’ compensation insurer about the accident. They must include your job details, how the injury occurred, and any medical treatment you’ve received. If the employer reports incorrect information or fails to act, your claim may be delayed.

Time Limits for Filing

In most states, the employer must file the first report within seven days after learning about the injured employee. Missing this deadline can affect your claim approval and delay payments for medical bills or wages. Always confirm that your employer filed the form with the correct workers’ compensation board.

Step 3: Seek Medical Treatment

Getting prompt medical attention is essential for your health and your claim. If you are seriously hurt, go to the emergency room or ask for first aid right away. The workers’ compensation insurance coverage will generally pay for all reasonable medical care related to your injury.

Choosing a Doctor

Depending on your state, you may need to see a doctor approved by the insurance carrier or your employer’s plan. A licensed medical provider can assess your injury or illness and determine if it is job-related. Always follow their advice and attend every appointment to protect your workers’ compensation case.

Keep Records of All Medical Visits

Keep copies of all medical records, prescriptions, and bills. These documents show the nature of your injury and the medical treatment you received. Your workers' compensation claim lawyer and the insurance company may use them to confirm your supporting documentation during the claim investigation.

Step 4: The Insurance Company Reviews Your Claim

Once the employer or insurance carrier receives your report, they begin the claim investigation. This step is when the insurance company reviews all documents, medical reports, and witness statements to decide if you qualify for benefits.

Investigation Process

The insurance carrier gathers details from you, your employer, and the medical provider. They will determine if your job truly caused the injury or illness. Cooperation during this stage helps speed up the process and supports a fair review of your claim.

Approval or Denial of Benefits

If the insurance carrier agrees, they issue claim approval and start paying benefits. If they deny your claim, they must explain why. A denial can happen if the supporting documentation is missing or the insurance company believes the injury occurred outside of work.

Step 5: Receiving Workers’ Compensation Benefits

Once your claim is approved, you start receiving benefits. The amount and length of benefits depend on your injury or illness, your job duties, and your recovery progress.

Types of Benefits You May Receive

1. Medical Benefits: Covers all approved medical bills and medical treatment.
2. Disability Benefits: Replaces part of your wages while you recover.
3. Rehabilitation Benefits: Pays for therapy or job training if you can’t return to your old job.
4. Death Benefits: Provides support to dependents if a work-related injury causes death.

These benefits help the injured worker recover and protect their family from financial hardship.

How Long Do Benefits Last?

In most states, benefits continue until the injured employee returns to work or reaches maximum recovery. Some disability benefits may extend longer depending on the workers’ compensation insurance policy and your doctor’s report.

Step 6: Returning to Work

When your doctor clears you, you may return to your job or take a light-duty assignment if full work is not possible. Your employer or insurance carrier must follow the doctor’s instructions regarding work restrictions.

Light Duty or Modified Work

Employers may offer light-duty assignments or temporary roles while you heal. This lets the injured worker earn income without worsening the injury or illness. Always confirm that the tasks are safe and approved by your medical provider.

Disputes Over Work Restrictions

Sometimes, disagreements happen between the doctor, the insurance carrier, and the injured employee about returning to work. If that happens, your lawyer can help resolve the issue before the state’s workers’ compensation board.

Step 7: What Happens If Your Claim Is Denied

If your claim is denied, it does not mean the end of your case. You have the right to appeal and present more supporting documentation to the workers’ compensation board.

Common Reasons for Denial

• Late Reporting: You missed the deadline to tell your employer about the injury or illness.
• Lack of Medical Proof: The insurance company believes your employee’s injury was not job-related.
• Incomplete Forms: Missing or inaccurate claim submission details.
• Preexisting Condition: The insurer claims your pain existed before the work injuries occurred.

Each reason can be challenged with strong medical records and legal help.

How to Appeal a Denied Claim

You can request a hearing before the workers’ compensation board to explain your case. During the hearing, your attorney presents new evidence, medical reports, and witness testimony to protect your rights and fight for your benefits.

Your Rights During a Workers’ Compensation Claim

Every injured employee has rights during the workers’ compensation claims process. Knowing these rights helps you protect your benefits and prevent unfair treatment by your employer or insurer.

Protection Against Retaliation

Under New York Workers’ Compensation Law § 120, it is illegal for an employer to fire, demote, or discriminate against a worker for filing a claim. This “discrimination” provision protects any injured worker who requests a claim form or testifies in a workers’ compensation case.

Every employee should feel safe speaking up about a work-related injury without fear of losing their job or facing unfair treatment from their employer.

Right to Legal Representation

You have the right to hire an attorney for help at any time. An experienced personal injury lawyer will explain your rights, deal with the insurance company, and guide you through the workers’ compensation process. Having strong legal support gives you peace of mind and ensures no one takes advantage of you while your workers’ comp claim is pending.

Confidentiality and Privacy

All personal medical records and claim details are kept private. Only the parties involved in your workers’ comp claim may view them. This rule helps protect your personal information. You can trust that your health and employment information will stay secure and will only be shared when it is necessary to support your workers’ compensation case.

Common Mistakes to Avoid When Filing a Workers’ Compensation Claim

Filing a workers’ comp claim can be confusing, especially when you are injured and trying to heal. Many injured workers lose benefits because of simple errors that could have been avoided. Here are the most common mistakes and what each one means:

• Not Reporting the Injury Quickly: Waiting too long to tell your employer about your injury or illness can hurt your claim. Most states have strict deadlines, and missing them can delay or even cancel your benefits. Always report your work-related injury as soon as it happens to protect your rights.
• Failing to Seek Medical Treatment Immediately: Getting immediate medical attention is very important. When you delay seeing a medical provider, the insurance carrier might claim your injury is not serious or not related to your job. Quick care helps you recover and proves that your work caused the injury.
• Incomplete or Incorrect Forms: Filling out claim paperwork incorrectly is a common mistake in the workers’ compensation claims process. Missing details like the date, time, or description of how the injury occurred can slow the claim investigation or cause a denial. Always double-check your forms before submitting them.
• Not Keeping Supporting Documentation: You must save every piece of paper related to your injury. Medical bills, medical records, and supporting documentation help show the true cost of your medical care. Keeping these records organized makes it easier for your workers’ compensation lawyer to prove your case.
• Skipping Doctor Visits or Ignoring Instructions: Skipping check-ups or ignoring your doctor’s advice can hurt your workers’ compensation case. The insurance company may say your condition is improving when it’s not. Following your doctor’s orders shows that you’re serious about getting better.
• Talking Directly to the Insurance Company Without a Lawyer: The insurance company is not on your side. They may ask confusing questions or use your words against you to lower your benefits. Having a workers’ compensation attorney speak for you ensures your rights are protected and that you get fair compensation.
• Returning to Work Too Soon: Some employers pressure injured workers to return before they are ready. Going back early can make your injury or illness worse and may affect your ability to get more benefits later. Always wait until your medical provider clears you to return safely.
• Not Understanding the Deadlines: Each step of the workers’ compensation process has a time limit. Missing deadlines for claim submission or appeals can result in lost benefits. A lawyer helps track important dates and keeps your claims process on schedule.

Avoiding these mistakes helps ensure that your workers’ compensation insurance claim goes smoothly and that you receive benefits without unnecessary delays.

How Our Workers’ Compensation Lawyer Can Help

Davidoff Law handles every part of your workers’ compensation case from start to finish. Our team helps you gather documents, explain your rights, and fight for full benefits under the law. With our help, you can focus on recovery while we handle the rest.

Managing the Entire Claim Process

Our lawyers handle every part of your workers’ compensation claims process from start to finish. We make sure every form, document, and deadline is met correctly so you can focus on healing.

Our team also speaks directly with your employer and the insurance carrier to make sure all updates and medical information are accurate. Having Davidoff Law manage the full claims process helps you avoid stress, confusion, and costly mistakes that could delay your benefits.

Negotiating Settlements

Davidoff Law carefully reviews your medical condition, wages, and future needs before discussing any settlement. We talk directly with the insurance company and fight for fair compensation that covers all medical expenses, lost wages, and any long-term care you might need.

Our experienced lawyers understand how the workers’ comp claim system works and use that knowledge to protect your rights. With experienced negotiation skills, we make sure no injured worker settles for less than what they truly deserve.

Representing You at Hearings

If your claim is disputed or denied, our legal team represents you before the workers’ compensation board. We prepare all supporting documentation, gather medical records, and call witnesses to strengthen your case.

During the hearing, we explain the details clearly and present strong evidence showing that your injury is job-related. Having Davidoff Law by your side ensures your workers’ compensation case is presented professionally and that your voice is heard.

Frequently Asked Questions About Workers’ Compensation Claims

How long do I have to report my injury?

You should report your work-related injury to your employer as soon as possible. In New York, it’s best to do this within 30 days.

Who pays for my medical treatment?

Your workers’ compensation insurance covers all approved medical treatment, including hospital visits and therapy.

Can I choose my own doctor?

You may be required to see a doctor approved by your employer’s insurance carrier, but you can switch if needed after approval.

What happens if my employer doesn’t have workers’ compensation insurance?

You can still file with the state’s workers’ compensation board, which may cover benefits even if your employer lacks proper insurance.

Am I eligible for benefits if my work injuries are minor?

Yes. Even if the work injuries you sustained seem small, you may still be eligible for workers’ compensation benefits. Many injuries get worse over time, so it’s important to report them and get checked by a doctor right away. Filing early helps protect your right to receive benefits if your condition changes later.

Contact Our Queens Personal Injury Lawyers for a Free Consultation

If you suffered a job-related injury or illness, Davidoff Law is here to help. We guide every injured employee through the workers’ compensation process and handle all communication with your employer or insurance company. Our experienced team fights to protect your rights and ensure you get the care and support you deserve.

We offer a free consultation to discuss your claim and answer your questions. Contact us today to learn how we can help you recover compensation and move forward after your injury.