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The Stepford Files: What the Perfect Workers’ Compensation Claim Process Should Look Like

Posted Charles E. Schmidt, Jr. on Feb 14, 2015 in Workers' Compensation

We all have ideas of what perfection entails. Perhaps it is something small, like a five minute commute to work with no traffic, or something big, like a promotion to thank you for your tireless effort and hard work. We see the perfect life for ourselves involving a nice car, a nice house, and children who are always polite and happy.

No matter what your idea of perfection is, you probably have high expectations—after all, perfect is a high standard. Of course, things in life rarely go perfectly. You probably hit traffic coming to and from work, and the best thanks you get for hard work is an offhanded “thanks.” Your car is good enough, your house needs a new roof, and your kids roll their eyes at you and talk back from time to time.

While most people do not expect to be perfect, having an ideal goal in mind helps you steer your way in the right direction, even if you never anticipate meeting perfection face to face. We like to think about workers’ compensation claims in the same way—they will rarely go according to the plan, but knowing the plan can help you know what to expect should you hit a bump in the road.

The Perfect Workers’ Compensation Claim: A Story

Kate is a nurse in a local assisted living facility, and has been for several years. Recently, she hurt her back while helping a patient, but since she had the next two days off, she decided to see if it sorted itself out on its own. She called in sick for work on the day she was supposed to return, and went to see her doctor. Her doctor discovered a serious sprained muscle, which could require several weeks away from her full duties.

While she has 21 days from the date of her injury to inform her employer, she called her supervisor after leaving the doctor’s office to let him know about the incident. This started the clock for her employer to accept or deny the claim—also 21 days—but her employer is prompt in getting the paperwork together for Kate to fill out and return to him. After a few days with the paperwork, Kate returns it to her supervisor, who submits the claim. Kate is well ahead of her 120 day limit to file her workers’ compensation claim after her injury.

Now, Kate’s priority lies in documenting and following her recovery. Her employer’s workers’ compensation insurer will probably initially offer a low offer, but Kate can provide thorough documentation on the severity of her back injury, and eventually the two agree on a fair settlement. Kate will receive compensation for her medical expenses related to the injury, as well as a percentage of her average weekly wage until she returns to work.

When Kate is allowed to return to work in a few weeks, she will need to be on light duty for a while, as recommended by her doctor. Her supervisor has already designated a much easier job in the billing department for her while she heals, and she will be able to return to her original duties when the doctor determines she is ready.

When Life Isn’t Perfect, Let an Attorney Help

Anyone with their own workers’ compensation story would probably laugh at the above scenario. Most workers’ compensation claims hit a bump in the road at some point, which can complicate the case exponentially. Knowing how a case should proceed, however, can give you appropriate expectations that allow you to protect yourself when you are being shortchanged in any way.

Getting hurt at work is far from a perfect scenario, but with our help, we can ensure that your workers’ compensation process is as ideal as possible. Call us today to discuss your claim, and we can get started now.