The Work Comp Claims Process - Rasmusson Law Offices, PLLC

Workers Compensation is a form of insurance carried by employers. This coverage provides benefits to employees that sustain an injury or illnesses through their employment. The claims process for work comp claims can be tricky.

Workers’ compensation claims provide the injured worker with a variety of benefits. These include medical benefits, wage loss and indemnity benefits, vocational rehabilitation benefits, and even death benefits. These benefits apply to both occupational diseases and work-place injuries. However, the difference lies in the process of filing a claim and proving the link between the job and the illness.

1. Filing a Claim

Step one in any workers’ compensation claim is filing the claim. Unlike workplace injuries, occupational diseases develop over time and over multiple shifts. This makes it difficult to understand the specific cause of your illness. But in order to file a claim for an occupational illness, you need to be able to directly link your disease and symptoms to your job. It’s important that you file a claim quickly after an injury or after being made aware of your illness.

Obtaining a medical diagnosis from a licensed physician that links the illness to work duties or conditions is a key factor in occupational disease claims. Once you have this diagnosis and it is clear that your condition is a result of your occupation, you need to give notice to your employer. Workers who develop an occupational disease must notify their employer within a year. The year starts from when the worker first knew, or should have known, that their disease is work-related. Failing to report it to your employer within this timeframe prohibits you from obtaining these benefits.

If you experience an injury at work, notify a supervisor immediately. Timely reporting helps ensure your claim is processed smoothly.

Often times your employer will file a claim for you after being notified. However, this is not always the case. You can file a claim yourself with the Employment Relations Division of the Montana Department of Labor & Industry. You can also contact Rasmusson Law Offices, PLLC and we can help you file your claim. Do not delay because in most circumstances the injured worker only has thirty (30) days to file a claim in Montana.

2. Proving the Link Between Job and Illness

Doctor taking notes with a patient in an exam room.

An occupational disease claim’s success is heavily reliant on proving that your illness or disease is caused by or related to your work conditions and duties. The easiest way to link these two things is through a medical diagnosis. Seeing your doctor when you start experiencing symptoms and being completely honest about your daily work duties can help you create this link quickly and efficiently. It is important to keep in mind that some exposures can take a long time to develop into an illness which can make diagnosing the illness difficult in relation to the occupation.

Keep your doctor informed about your symptoms and job duties. This will allow them to serve as an expert witness for your claim. Their medical expertise and knowledge of your medical status allows them to provide solid evidence of your injury or occupational disease. This is especially important if you have a pre-existing condition that affects the same body part or function as the condition in your claim.

A detailed record of your work history can help link your illness to specific job tasks or conditions that caused it. For example, if you can show that a specific work site had asbestos and after working on that site you began having respiratory issues, this work history provides a persuasive argument to support your claim.

3. Settling a Claim

It’s no secret that occupational disease claims can be complex and challenging. Regardless of these challenges, a worker suffering from an occupational illness is entitled to workers’ compensation benefits. However, without experience with these claims it may feel like you have nowhere to go if your claim is denied. It is not uncommon for employers and insurers to contest a claim seeing the requirement to prove the relation between illness and the job can be quite difficult. Finding the right attorney who will fight for you and your claim can be the deciding factor when it comes to getting your rightful compensation.

While workplace injuries tend to have clearer liability, insurance adjusters can still try to deny your claim. Knowing your rights and having an advocate can save you time and stress.

Once you file your claim, continue treatment for your injury or illness. Be sure to follow your healthcare provider’s advice. The insurer will investigate the claim and initiate benefits upon acceptance of the claim. Keep in mind, each claim comes with their own challenges and their own strengths.

Eventually each claim comes to a point of settlement or a need for closure. For example, in Montana medical benefits close 60 months from the date of injury listed on the claim. You may settle before the 60 months run out or wait until you approach the 60-month deadline. Settlement can be a tricky process. Insurers are much more familiar with calculating a claim’s value compared to that of someone who has never handled a claim before. Factoring in lost past wages, lost future wages, future medical expenses, vocational benefits, and many other details. Having an experiences attorney prepare your claim to get the best settlement for you can make a very large difference.

Take Aways

Any worker who has developed a disease or illness as a result of their employment is entitled to file a Montana workers’ compensation claim. If you’re not sure whether your condition is a result of your employment, you can consult with an experienced workers’ compensation attorney. A lawyer can help guide your claim in the direction of a fair settlement.

Call Rasmusson Law Offices, PLLC today at (406) 549-3323 to start with a free consultation.