Workers’ comp claim is the politically correct name for a type of insurance first developed in Prussia (1881) – it was then called workmen’s compensation insurance. Workers’ comp claim is a form of insurance that provides financial support to those employees who become ill or injured during the scope of their professional responsibilities. This financial support includes coverage for the following –
- Payment for lost wages.
- Reimbursement for medical expenses.
- Payment to help rehabilitate the employee.
- Death benefits paid to the families of those who have been killed on the job, among others.
Worker’s compensation was designed to avoid the lengthy, often – combative process when an employee would be required to prove the employer’s (or other related party’s) fault before receiving compensation for workplace injuries.
Most employers in the state of Georgia buy worker’s compensation coverage to help manage the available benefits. However, it can be challenging to enforce the support offered by the workers’ comp claim insurance, which is why it is smart to speak with a Georgia worker’s compensation attorney if you are involved in a worker’s compensation situation. A Georgia worker’s compensation attorney can help navigate what can be a complicated process with comprehensive paperwork.
Documents Required to File a Worker’s Compensation Case
Like any legal or insurance case file, it is critical that the appropriate forms be used and completed if the case is going to be adequately documented. It is also important should the claim be contested. Even if the claim is compensable, appropriate paperwork will be required as a basis for the case approval.
Let’s take a look at what documents are typically required to file a worker’s compensation case.
- Statements of fact that are provided as oral, written, or recorded information.
- Statements from witnesses the delineate their perceptive provided as oral, written, or recorded information.
Oral statements should be documented in writing with great care – explaining what was discussed, the place of the discussion, and the date/time. A detailed report of the conversation should be written as soon after the interview and included in the worker’s compensation file. Include the reason this statement was prepared orally rather than in writing. This type of documentation is a commonplace practice in these matters.
Additional documentation for the worker’s compensation file should include these suggestions. Claimants are advised to be extremely vigilant and accurate when completing all forms and gathering all relevant information –
- Proper ID for the injured employee.
- A written diary that has been kept by the claimant regarding –
- Any facts.
- Action Plans, to name a few.
- Videos/Photographs of the accident area and scene.
- All medical records regarding –
- The facts of the worker’s comp causal relationship.
- Past medical records that may have a bearing on the worker’s compensation claim.
- Any examinations or consultations with medical examiners – Independent or otherwise.
- Reports/testimony from professional experts or advisors.
- Utilization reviews, if applicable by medical case managers.
- The claimant’s –
- Lifestyle documentation.
- Physical background
- Any investigative reports generated by independent sources like OSHA, Emergency Medical Technicians (EMT), Union Representatives, safety inspections, plus the Police or the Fire Department.
- The claimant’s personnel records.
- Claim records regarding the worker’s comp case from the insurer, the employer, or any other relevant service office.
- Private Investigator reports regarding social media accounts and relevant activities.
- Business records regarding –
- Vendor contracts.
- Employee training programs and evidence of participation.
- Salary Records.
- Disciplinary Actions.
- Union Membership information.
- Business records regarding –
A Word about Timing
As with most legal matters, it is critical to begin documenting any worker’s compensation claim as soon as possible. Worker’s compensation attorneys in Georgia are trained to guide a worker injured on the job through the often-complex process. Preparing early helps avoid these issues that can develop if a worker’s comp case is needlessly delayed –
- Witnesses and other parties may begin to alter their accounts of the accident.
- Physical evidence may become inadmissible due to poor handling by professionals, or even go missing.
- Opportunities to perform essential research may be lost.
- Opinions from medical experts may be jeopardized.
- A lost opportunity for subrogation, among others.
Worker’s comp cases must be appropriately documented. This documentation should support the facts of the case and the causal relationship for the accident. It is best to begin to document a worker’s compensation case when the accident happens and, of course, after the claim has been reported.
The amount and depth of documentation will vary based on the claim’s specific circumstances. However, a worker’s compensation case must meet the requirements of best claim practices. Appropriate documentation evidences that the matter is being appropriately managed from a technical perspective, and supports the interests of all those concerned.