If a Worker Does Not Report an Injury Right Away, Can They Still Make a Claim?

work injury

The simple answer to the question is, “Yes.” A worker can always file a claim for an injury, even if it is not filed on the date it happened. The real question, though, is will the claim be paid or denied. In most circumstances, a claim filed some time after the work injury will most likely be denied. That does not mean the worker will never receive payment. It means that the worker needs to hire an attorney who handles workers’ compensation cases and pursue the claim utilizing all the remedies allowed. The best policy is to file a claim as soon as a worker suspects they have a claim. Do not wait until the next day. File the claim immediately.

TIME DEADLINES

A worker who files a late claim has several obstacles to overcome. The first problem is the time deadline. Some companies have a policy requiring claims to be filed within a certain time limit. That policy should be spelled out in an employee manual. Every employee should find out if there is such a policy, and if so, what the deadline is. The time frame will be short, so all workers need to be aware of that policy. Whether or not the employer has a deadline, every state has one. Again, workers need to know what that time period is. The employee manual would also be a source of that information. Any attorney who practices workers’ compensation law will know the deadline. Call any attorney’s office and they will probably tell you what the deadline is in their state. Again, always file the claim first and then call an attorney. The lawyer can always amend the claim if there is a problem with the original document. Most times, the date the original claim was filed will be the governing date, not the date of any amendment.

SITE OF INJURY

A second problem with a late claim is proving the injury occurred at work. Take the example of a worker with a back problem. They allege that it happened at work when they picked up a heavy object that was not part of their normal job. If the claim is not filed until a week after the incident, then the employer is going to argue that the employee could have injured their back at home anytime during that intervening week. That is a potentially valid defense and, other than saying it is not true, it is hard for the employee to counteract that claim. The employer, speaking through its workers’ compensation insurance carrier, will ask the employee the following questions:

If the back injury was severe enough to file a claim, then why did you wait a week?
Were you able to work during that week?
Did you injure the back again during that week?
What kind of activities did you do at home during the week?
Did you tell any of your fellow employees about the injury, and if so, what date did you have the discussion?

An employee can see where this is going. An employer and insurance carrier are always suspicious of an injury that occurs while not at work but is claimed as work related. Filing a claim the same day at work removes all of these problems.

PROBLEMS OF PROOF

A worker always has to prove that the injury occurred at work. This is true even if the claim is filed the same day. The employer will ask fellow workers if they saw anything unusual – like the claimant holding his back and acting in pain after lifting an object. It may be that workers gathered around to help the injured worker. That is the type of proof that wins a case. A late claim is different. Workers may have trouble remembering what happened on Tuesday of last week. Memories can fade fast, especially if the claimant did not tell anyone they hurt their back. If you suspect even the remote possibility of an injury and claim, tell your fellow workers about it right away. Then they will remember the incident and be able to substantiate that it happened at work on the date claimed. A late claim with good proof can win and recover benefits. It just helps for the injured worker to have made his potential injury known.

BENEFITS

Workers compensation offers three types of benefits for workers. One is payment of medical bills. An employer must pay all medical bills with no deductibles for any injury that is work related. Even if the employee did not miss any work other than a visit to a physician, all bills are payable in full. This is a tremendous benefit for an employee. Remember that medical bills are payable no matter how insignificant the injury is as long as it is work related. For example, a visit to the doctor may result in a diagnosis that confirms the injury is minor. A prescription and a day or two off from work is all that the claim amounts to for the employee. That worker still has no medical or drug bills to worry about.

The second benefit is temporary disability benefits. This is simply payment for being out of work for a period of time. The amount the worker receives is based upon their salary and state law. The idea is that the employee will return to work at some time in the future, with or without restrictions. A worker with a back injury may go back with weight restrictions on lifting. Those restrictions may be for a defined period of time, like one or two months. The employee normally receives full pay during that time.

The final benefit is permanent disability. It is normally expressed in a percentage which is used to determine the amount of money owed. Sometimes, the worker settles for this amount and does not return to work. Other times, the worker can return even though they have a permanent disability. They are still able to work but they are being compensated for the fact that their back is not back to normal and never will be. The money pays for the worker having to live with a back that is not what they had before the injury.

SUMMARY

File the workers’ compensation claim as soon as possible. Do not let a period of time between the injury and filing the claim stop you. The worst that can happen is that the claim is denied. The best result is that you prevail because the injury really happened at work. Workers’ compensation attorneys know had to handle these types of cases and obtain benefits. Get your evidence together and seek your benefits.