How Long Does It Take To Approve Or Decline A Workers' Comp Claim?

By Rebecca Batisto

How Long Does It Take To Approve Or Decline A Workers' Comp Claim?

There are few things more stressful than waiting to see if your workers’ comp claim is approved or declined. In many cases, your financial security can ride on that decision. But, as with most things when it comes to work-related medical insurance, the length of time between filing and being approved/denied all depends on the state in which you are filing the workers’ comp.

Your First Steps

First, you need to be aware of the rules when it comes to reporting your injury/accident to your employer and the insurance company. The timing is different for each state, with some requiring you to contact them as soon as possible and others giving upwards of a month. You can find more detailed information about how long you have to file a workers’ comp claim here: Is There A Deadline To Claim Workers’ Comp? If you do not file within those time frames, you may risk losing your workers’ comp entirely.

Workers’ Comp Investigations

Often, workers’ comp claims are processed rapidly, but that isn’t always the case. Your claim may need to be investigated by either the insurance company or your employer. You should cooperate fully with this investigation, which can include interviews with your coworkers and the review of medical files and accident reports.

This can be a stressful period, but thankfully investigations are usually wrapped up quickly. In most states, there are strict timetables for these investigations, between 14 and 30 days. If an insurance company requires more time, they do have the option to ask for an extension.

That said, a period of 30 days after an accident while waiting for benefits to kick in, can feel like an eternity, especially when you have bills piling up. What are your options for this period?

Medical-Related Benefits

Here is the good news: in most states, you don’t need to wait for some of your benefits to kick in.

Even before your workers’ comp claim is approved or denied, your employer (or your employer’s insurance company) usually pay for your medical bills. This is especially important if you require immediate treatment. If you are injured on the job, chances are that your employer will know about it. If not, inform them as soon as possible after the accident. (Read more about filing forms here: https://www.normandyins.com/blog/2019-02-20-filing-a-workers-compensation-claim-the-forms)

Remember that you must still file a workers’ comp claim promptly. After you’ve filed, send a copy of your medical bills to your employer or their insurance company so they can be processed. Alternatively, you could tell your doctor that your injury was caused in the workplace and that they should bill your employer or insurance company directly. You should receive payment for your workers’ comp soon after.

Non-Medical Benefits

Unlike medical benefits, you must officially file a workers’ comp claim to your employer or insurance company before you can start to receive disability benefits. Unfortunately, you must also wait to see if you’ve been approved or denied. If you’ve been denied, you also have the option to appeal this decision.

Your benefits, both medical and non-medical, will end after your doctor tells your employer that you are capable of returning to work.

It’s impossible to know exactly how long it will take for you to be approved or denied for workers’ comp benefits. It all depends on the nature of your injury and the level of investigating that an insurance company or your employer needs to do. At Normandy Insurance, we promise that we will do whatever we can to speed up the process and make sure that you will receive the benefits that should be coming to you. If you would like more information about how we handle claim investigations and benefits, we invite you to contact us today!

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