Filing the Claim
Your employer is responsible for filing the workers' compensation claim with its insurer and the Department of Industrial accidents within 7 days of being aware that you were injured and that you have been out of work for more than 5 days. The only way you can be sure it is filed correctly and on time is to review the claim form and check the date that the form was submitted to the insurance company. Some companies may try to avoid paying penalties by stamping materials with a back date so that it appears they are complying with time deadlines when they are not. The Workers' Compensation Act requires that you receive a copy of the filed claim and it is your responsibility to ensure that you receive and review that documentation.
The insurance company is also held to time deadlines. They must either pay or deny payment within 14 days or pay a $200 penalty. If the insurer still has not made or denied payment within 60 days, they face a $2,000–$10,000 penalty fee from the Department of Industrial Accidents.
If your claim is denied by the insurance company, this does not necessarily mean the end of the road for your claim. The form that you will receive should specifically state the reasons that the insurance company has denied your claim, but the insurance company is not the final authority in these cases. You can file a claim with the Department of Industrial Accidents, which will assign an administrative judge to hear your case and decide whether you are entitled to receive compensation benefits. The most important thing you need to do is save all of your documentation related to the case (e.g., accident report, disability note, medical documents). Also, save the denial form and the envelope in which was received. In the event of a time penalty issue, the dates on these documents could be crucial to your case.