Workers' compensation provides medical and wage-replacement benefits for job-related injuries regardless of fault, but claimants must notify their employer within a strict deadline that varies by state — sometimes as short as 30 days.
Missing the notice deadline is one of the most common reasons legitimate claims get denied, even when the injury itself is not disputed.
Many states require or strongly incentivize using an employer-designated physician, at least for the initial evaluation.
Notifying your employer and filing the state claim form are two separate steps — both are typically required.
Insurers can accept, deny, or delay a claim; a denial is not the final word and can typically be appealed.
Every state provides an administrative appeals process, often before a workers' compensation judge, separate from the regular civil court system.
Filing deadlines, court structures, and procedural rules that materially differ from state to state.
Retaliation for filing a legitimate workers' compensation claim is illegal in every state, though employers sometimes attempt to frame a termination as unrelated — a pattern that itself can become part of a legal claim.
A denial can typically be appealed through the state's workers' compensation board or a similar administrative body, and many denials are successfully overturned or negotiated on appeal.
An aggravation of a pre-existing condition caused by work activity is commonly compensable, even though the original condition itself was not work-related.