Workers’ compensation claims can take weeks or months to resolve. The amount of time it takes to resolve a claim depends on the severity of the injury, the state in which the claim is filed, and the insurance company’s claims process. In this blog post, we’ll explore the factors that affect the length of time it takes to resolve a workers’ compensation claim.
How Long Will the Investigation of the Claim Take?
To get workers’ compensation payments, you must disclose your injury to your employer within certain time restrictions in every state. Before receiving benefits, several states require the injured worker to submit a workers’ compensation claim with the state agency. State-specific notification and claim regulations vary. You risk losing part or all of your advantages if you do not follow the right method. Please choose your state from the drop-down menu on our page about claiming workers’ compensation to see its regulations.
After filing a claim, the insurance company (or another decision-maker) will conduct an investigation. Typically, the claims administrator will meet with you and your employer and evaluate your medical records, accident reports, and other paperwork. You must comply with the insurance company’s useful information and document demands. However, you should consult a workers’ compensation attorney if you have any issues with the enquiry. For instance, if the insurance company is not answering your phone calls or you suspect you are under surveillance, it might be prudent to consult with an attorney.
In most states, the employer or insurer must determine your eligibility for workers’ compensation payments quickly or within a reasonable time. In addition, several states have rigorous timeframes for granting or dismissing a claim, often between 14 and 30 days. The insurance company may request an extension in certain areas if more investigation is required.
If the insurance company misses the deadline for making a decision or requesting additional time, it may incur a financial penalty. Or, in certain areas, if you do not obtain a timely ruling, your claim will be regarded automatically approved.
In general, you should get a written notification on the status of your claim within a few weeks. Contact your insurance adjuster or claims administrator if you haven’t heard from the insurance company. If you do not get appropriate information, call your state’s workers’ compensation department or a competent workers’ compensation attorney. Some states also have online sites where you may monitor the progress of your claim.
How does an insurance company influence the duration of workers’ compensation settlements?
Because the insurance company pays for workers’ compensation payments in most instances, their actions significantly influence the case’s progression. If an insurance company (or its attorney or employer) is sluggish to evaluate the case, follow up, or establish deadlines, this may substantially impact the case’s timetable.
Generally, cases will take longer if, for instance, an insurance company argues the amount of permanent disability you have been assigned. If your doctor determines that your impairment is 15 per cent, but the insurance company’s doctor determines that it is just 5 per cent, the case duration may vary significantly.
The impairment rating significantly influences the amount of workers’ compensation payments to which you are entitled; hence it is the primary focus of insurance companies. Disputes over the permanent impairment assessment may often add roughly five months to the length of a case.
How Delays Affect Workers’ Compensation Settlement?
In most circumstances, a worker would believe that a delay (not induced by them) contributed to the length of their case. It takes insurance companies time to examine a claim, juggling several cases simultaneously. Processing this data takes time and might create major delays in the process.
Typical Delays in Workers’ Compensation Cases
- Typical sluggish reaction times
- Problems obtaining an appointment with a certain doctor or specialist
- Slow response times to get medical records from hospitals and clinics
- Ignoring medical treatment demands
- Absence of a response from a lawyer
- Delays in the scheduling of significant events (like independent medical examinations or depositions)
While many of these delays are unavoidable in a regular workers’ compensation case, there are instances in which an insurance company would intentionally prolong the processing of your claim. They may do this in the hopes that the worker would abandon their claim or settle for a lesser sum.
How to Accelerate the Process of Filing Workers’ Compensation Claims
Some methods injured employees may take to expedite the workers’ compensation claims process to the maximum extent permitted by South Carolina law. Wounded workers should take three specific actions:
- Immediately report their injuries and submit their claim;
- Obtain and arrange all necessary documents and data for a solid first claim; and
- Consult a skilled South Carolina attorney familiar with the Workers’ Compensation claims procedure and aware of the required information.
It can take a long time for a workers’ compensation claim to be resolved. The time it takes can vary depending on the severity of the injury, the amount of time it takes for the worker to recover, and the case’s complexity. In some cases, it can take years for a claim to be resolved.
If you have been injured at work, it is important to contact a workers’ compensation attorney to discuss your case. Gaylord & Nantais Workers’ Compensation Attorney can help you get the compensation you deserve. Call us at (562) 561-2669 to book a free consultation.