Importance of Clarity in Workers’ Compensation Claims

Workers’ compensation law is a quite complicated and nuanced area of law. Employers should actively seek out clarification on new and existing workers’ compensation regulations and laws, as well as endeavor to have a good understanding on the way the current process works. Failure to have a firm grasp on the workers’ compensation system and the laws associated with it can prove disastrous for both the employer and the injured employee. It is essential that all involved in the workers’ compensation system provide as much clarity as possible in every workers’ compensation claim.

At the beginning of every workers’ compensation case, a worker who has sustained a work related injury must provide a written report. This report details the circumstances surrounding the injury as well as the basic nature of the injury sustained by the worker. It is very important for the worker to be as detailed as possible in this report because the employer and the workers’ compensation insurance provider will both use this report as the “jumping off point” for their respective investigations. The more detailed and accurate this written report, the better starting point the employer and insurance provider will have.

After the initial claim is submitted to the insurance company, the claim will be reviewed and either accepted or denied. If a written claim is not sufficiently detailed or if it is inaccurate, that will greatly increase the chances of it being rejected. Providing the most amount of detail and, more importantly, making sure those details are accurate, will speed up the process. Accuracy will reduce the chance of the insurance company rejecting the claim.

After the claim is eventually accepted and approved by the insurance company, the next issue is the amount and nature of benefits that will be granted to the worker claiming a work-related injury. It is essential that the report to the insurance company is accurate as that will be greatly determinative for the amount and nature of benefits awarded to and received by the injured worker. If the insurance company receives an inaccurate report or case file, it will be impossible for the injured worker to receive the proper amount of benefits.

If you have questions about the contents of a workers’ compensation report, contact us today at (714) 252-7078. We have extensive experience helping clients with this process.

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