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How Long Does a Workers’ Comp Claim Take?

Broken Arm Injured Worker Compensation Coverage.

If you have been injured at the workplace, you are entitled to file for workers’ compensation. Coverage does not happen automatically, however. You’ll need to notify your employer of the injury and fill out the appropriate paperwork to file your claim for workers’ comp. The workers’ comp insurance provider will then review and investigate the claim in order to make a determination regarding coverage.

Many injured workers are worried about their healthcare and their finances while the workers’ comp claim is pending. Do you need to wait for a final decision from the insurance company before getting covered medical care? How long will that take? Read on to learn about the time frame for obtaining workers’ compensation benefits in California, and call a seasoned California workers’ compensation attorney for help if you’ve been hurt at work and need help getting the benefits you are owed.

The Workers’ Comp Process

The time frame for your workers’ compensation claim is based around a number of statutory limitations imposed by California law. Your employer, the workers’ compensation insurance provider, and you yourself are bound by certain time limits.

First and foremost, your claims process cannot start until you start it. You have 30 days after your workplace injury to report the accident to your employer. We don’t recommend waiting the full 30 days, as it will limit your ability to get your medical care and workers’ comp benefits in a timely manner.

Once you report the injury to your employer, they have one workday to give you a workers’ compensation claim form. You’ll then want to fill out the workers’ comp form and get it returned as soon as possible. After you give your employer your filled-out workers’ comp form, they must give you a copy of that form and forward a copy to a workers’ comp claims administrator within a day.

Once the form is forwarded to the insurance company, they have one working day to authorize up to $10,000 in medical treatments. That way, you do not have to wait for the full investigation to be completed before obtaining necessary medical care.

If you are temporarily disabled because of the injury, the workers’ comp insurer must start issuing disability payments within 14 days of receiving knowledge of the injury. The same goes for permanent disability unless the employer offers the employee an alternative position they are able to perform that pays close to the same.

The workers’ comp insurance provider has 90 days to conduct a full investigation and make a final decision about your claim. Whether they choose to accept or reject your claim for coverage, they have 90 days to conduct their investigation and decide to reject your claim.

ºAlthough, if they later discover new evidence previously unavailable that undermines your claim, the insurer may deny your claim at that time.

Additionally, there are circumstances that can allow the investigation to take longer. For example, if a Qualified Medical Evaluator (QME) Panel needs to be scheduled or deposed, it can take from one to four months for a panel or deposition.

If you are dealing with a slow-moving workers’ compensation insurance provider, or if you have any other questions about your workers’ compensation claim, you need experienced legal representation on your side. Give us a call for help filing your claim or contesting a claim denial. We’re board-certified specialists in workers’ compensation. You don’t have to pay unless we recover on your behalf. Contact Invictus Law today for help.

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