When an accident happens at work that results in injury, it is important for employees to know that there is a system in place to provide them with relief. This is done with workers’ compensation insurance. Oftentimes, after an accident, victims are overwhelmed by physical, emotional, and financial burdens. It is because of this that workers’ compensation exists to give victims coverage for these damages. In order to receive the benefits that this insurance offers, the employee is required to report their injury to their employer and file a workers’ compensation claim.
How to File a Workers’ Compensation Claim
When an employee sustains an injury on the job, there are certain steps that must be taken to ensure a claim is filed in accordance with the law. This begins with reporting the injuries to their employer within 30 days of sustaining the injury or from realizing that the injuries they have are work-related. The following are additional steps that must be followed during this time:
- Report the job-related injury or illness to an employer
- Report the job-related injury or illness within 30 days in writing to the Office of Workers’ Compensation
- Complete the DCWC Form 7. This can be obtained from an employer, insurance carrier, or the Office of Workers’ Compensation
- Keep a copy of the completed forms, file a copy with the employer and send the original documents to the Office of Workers’ Compensation
- The DCWC Form 7A must be filed within one year of the injury. This can be obtained from an employer, insurance carrier, or the Office of Workers’ Compensation.
What do I do if my Claim is Denied?
It is important to know that it is always a possibility that a workers’ compensation claim can be denied. However, in the event that this happens, the decision can be appealed. The process of filing for an appeal can begin by requesting an informal conference with the District of Columbia Administrative Hearings Division. This allows an employee and the insurance company to meet with the claims examiner. During this time, the examiner listens to both sides of the issue and gives a written recommendation. This is done within 30 days. Regardless of what the recommendation states, this is not binding and either party can request a formal hearing if they disagree.
If one party wishes to request a formal hearing, they must file an application, attach a copy of the claim form, and sign the document. This can be done with the Administrative Hearings Division. After the request is received, an in-person hearing can be scheduled. This is done before a workers’ compensation judge where each party can question witnesses, submit documents, and make legal arguments. The judge can then make a written decision to mail to each party. This decision as well can be appealed to the Compensation Review Board. This also must be done within 30 days.
Contact our Firm
If you have become the victim of an on the job injury, it may be beneficial to speak with an attorney and the doctor that is treating you to determine how to make the process as easy as possible. AllianceMeds understands that a workplace accident can be challenging and is here to help. We will deliver your medication to your door using overnight delivery and cover any out of pocket expenses that may arise. If you have any questions about how we can help, contact AllianceMeds today.