The good news about workers’ compensation benefits is that at least some benefits start immediately. In most states, your employer must, at a minimum, pay your medical bills related to your work-related injury even before your workers’ compensation claim is formally allowed/accepted. Once your employer, your employer’s insurance company, or the state issues a notice that your workers’ compensation claim is allowed/accepted, you will then potentially be eligible for all other workers’ compensation benefits. Your entitlement to those benefits will depend on the particular circumstances of your case, including the severity of your injuries and your ability to return to work.
Medical Benefits Begin Immediately
All medical bills for treatment related to your industrial claim will likely be paid for by your employer, your employer’s insurance company, or the state (if the state is the insurer), immediately after you file a workers’ compensation claim. Your claim does not need to be allowed or accepted before the bills will be paid.
You do not need to have an open workers' comp claim before you can seek medical treatment. If you believe you were hurt on the job, report the injury to your employer and make an appointment with your doctor right away. Your doctor can begin providing you treatment and documenting your industrially related conditions.
If you have not yet filed a workers' comp claim, and you have received bills for medical treatment you believe is related to the industrial claim, file a workers’ compensation claim immediately. Then send a copy of those bills to your employer or its insurance company for processing and payment.
When you visit a doctor's office, tell your doctor that you have filed, or are filing, a workers’ compensation claim. Your doctor will then be able to bill your employer, or your employer’s workers’ compensation insurance carrier, directly.
In most states, employers are required to pay medical bills for treatment likely related to a work-related claim, even before the claim is formally allowed/accepted. If this occurs in your case, you will most likely not be responsible for paying those bills even if your workers’ compensation claim is later denied.
When Do Non-Medical Benefits Begin?
Temporary disability benefits (a.k.a. time loss compensation), permanent disability benefits (a.k.a. loss of earning power benefits), and other workers’ compensation benefits will not begin until your claim has been formally accepted/allowed. Before you receive a check for benefits, you will receive notice that your claim has either been accepted/allowed or denied. If your claim is denied, you may appeal that decision. Your benefits will not begin unless you win on appeal.
Even if your claim is approved, you will not begin receiving cash workers’ compensation benefits until you are entitled to these benefits. For example, in most states, your doctor must complete a form certifying that you are physically unable to work at the present time for you to be considered eligible for temporary disability payments, or time loss compensation.
You will stop receiving temporary disability benefits when your employer establishes sufficient evidence to show that you are no longer entitled to those benefits. For example, if your doctor determines that you are now physically capable of returning to work, your employer may cease your time loss compensation benefits.
If you have questions about your eligibility for certain workers’ compensation benefits, or you believe you are not receiving your full benefits, talk to a workers’ compensation attorney. An attorney can advocate on your behalf to ensure you receive the maximum benefits possible.