What Happens After You File A Workers Compensation Claim?


If you have been injured at work and are wondering what to expect after filing a workers compensation claim, you have come to the right place. You deserve to be compensated for your on-the-job injuries and the lost wages that come along with it.

It is not advised to pursue workers comp benefits without seeking the legal advice of a workers comp attorney in Los Angeles. From the moment you file a workers comp claim form, many things could go wrong or not as expected, which is why it is better to be legally represented by a skilled lawyer.

So, what happens after you file a workers comp claim in Los Angeles or elsewhere in California? We invited our lawyer from the Law Offices of Kropach & Kropach to answer this question.

What happens after you file the claim?

After filing a workers compensation claim, your employer must receive it, fill out the required fields in the form and sign it. After the form has been filled out by both the injured employee and the employer, the workers comp claim must be handed over to a claims administrator, which was assigned to handle all workers compensation cases on behalf of the employer (some claims administrators are employed by insurance companies and other organizations).

A copy of the completed workers compensation claim must be handed over or sent via email to the claims administrator, also known as a claims adjuster, within one working day after you filed it. Our Los Angeles workers compensation lawyer warns: keep the copy.

When the claims administrator receives the copy, he or she has to either accept or reject your claim within a reasonable period of time (which, according to California workers compensation laws, is 90 days).

What does it mean if my claim is ‘accepted’ or ‘denied’?

  • If the claims administrator accepts your workers compensation claim, your injury and all the expenses associated with it, including medical bills, lost wages, loss of earning capacity, must be covered by workers compensation. You will be receiving paid medical care for your on-the-job injury immediately after your claim has been accepted.
  • If the claims administrator, on the other hand, denied your claim, it means that he or she does not believe that your injury meets the required criteria to be covered by workers compensation. If you have received a letter from the claims administrator informing you that your workers compensation claim has been denied, you have a legal right to challenge the decision. In that case, it is absolutely vital that you seek the legal help of a Los Angeles workers compensation attorney to file the necessary papers in order to dispute the decision. Do not hesitate to do this, as there are strict deadlines.

What if the claims administrator does not respond?

If you have not heard back from the claims administrator within 90 days, and you have not received a letter denying your workers comp claim within that period, your claim may be automatically considered “accepted.”

How soon will I get back to work?

If you feel like you could get back to work after your workplace injury, you will have to consult with your primary treating physician about whether it would be safe for you to return to work while still recovering. If you have not fully recovered or have not completed your medical treatment, you will need your treating physician, employer, and your workers compensation attorney to decide what type of work you can do while recovering.

Contact the Law Offices of Kropach & Kropach to speak about your particular case today. Get a free consultation by calling our offices at 818-609-7005 or complete this contact form.

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