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Unfortunately, there is no average time for how long it takes to determine if you have a valid workers’ compensation claim. It could take as little as 15 days in South Carolina per S.C. Ann. § 42-17-10 if you and your employer agree on your compensation package immediately after your accident. However, if your employer contests your claim, it could take considerable time.
Getting hurt or becoming ill at work is stressful, as is filing a claim for the medical and financial workers’ compensation benefits you need while you recover from your injury. The filing process can leave you with a plethora of questions. However, the best way to understand your state’s laws is to review your case with a workers’ compensation lawyer in your area. Usually, this review is cost-free and obligation-free.
What Steps do I Follow to File an Effective Claim?
If you suffered a workplace injury, the first step to filing your claim is notifying your employer. You have limited time to make that notification (for example, South Carolina allows 90 days per S.C. Ann. § 42-15-20), and failure to comply can prevent you from receiving benefits. Once appropriate notification is made:
- Seek medical help from your employer’s physician
- Obtain, complete, and submit the required forms
- Seek proper legal guidance and support
A workers’ compensation attorney will help you navigate the claims process and the evaluation. In addition, they will explain the timing of each step, how soon you can expect to start receiving financial benefits, and how to appeal a denied claim.
How Is My Request for Benefits Evaluated?
Each state will have its evaluation process for workers’ compensation applications. The lawyer who handles your case will explain how your case details and the state’s procedures will affect your evaluation. Your application could be evaluated by:
- Your employer
- The workers’ compensation insurance company
- Your state’s workers’ compensation board
During your evaluation, you will answer questions about your accident, injury, or illness. In addition, it will include a review of your medical records, prognosis, and possibly an additional exam. Finally, the examiner might also interview others in your workplace, including coworkers, managers, and supervisors.
How Long does It Take to Start Getting Benefits After an Approved Application?
You will not receive compensation if you miss fewer than seven days of work. However, for injuries or illnesses that last longer than that, you can generally expect to receive benefits within a few weeks.
Your benefits will include all necessary medical care. You will also receive monthly financial benefits. In general, they will equal approximately two-thirds of your average weekly wages.
When you work with a workers’ compensation lawyer, they can explain whether you will receive temporary or permanent disability benefits. In addition, they will also calculate your weekly wages accurately to ensure you receive all the benefits you deserve.
Do I Have to Wait for Medical Care?
You should be able to start receiving medical care right away. However, you might have to see the healthcare provider your employer chooses. You should not have to wait for the approval of your application to get the medical care you need.
Do I Need to Hire a Worker’s Compensation Lawyer?
Whether you file an initial application, appeal, or negotiate a lump sum settlement, you can pursue a worker’s comp claim alone. However, there are benefits to hiring an attorney. Foremost, they can handle your claim while you focus on getting better.
A workers’ compensation lawyer can also help by doing the following:
- Determine your eligibility for benefits
- Explain the complex application process
- Guide you in collecting the required medical evidence
- Help you negotiate a fair and accurate settlement
- Understand your state’s laws
In doing all this, your lawyer ensures you receive all the benefits you deserve.
Your Appeal Options if Your Employer Denies Your Initial Application
For various reasons, an insurer or the state’s workers’ compensation board might deny an application for workers’ compensation’s medical and financial benefits. Common reasons for rejecting your request include the following:
- Missing the filing or notification deadline
- Disagreements on the cause of your condition
- Failing to meet your state’s criteria
- An incomplete or flawed initial application
If the examiner denies your application, a workers’ compensation lawyer could guide you through the appeals process. You can start by sharing your denial letter with your attorney stating the reason for the denial. Then, your lawyer will represent you at each stage of the appeals process, including a hearing with the Administrative Law Judge.
Get a Free Review of Your Workers’ Compensation Case Today
Are you concerned about how long it will take to determine if you have a valid workers’ compensation claim? Our workers’ compensation lawyers can help you effectively navigate the application process. We can also help you file an appeal if needed.
Contact one of our team members at Schiller & Hamilton today to get a free review of your case.