Workmen Compensation

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A claim for workers compensation benefits should be filed by the workman immediately after being injured while in employment and while performing his duties or when he is diagnosed with a disease which is related to his work. A delayed filing of the worker’s compensation benefits after an injury at work or after contracting a diseased related to his work can lead to the worker’s compensation insurance carrier to potentially deny his compensation benefits. A lengthy delay in filing of the worker’s compensation benefits which is determined from the injury’s date to the filing date can create doubt on the legitimacy of the compensation.

In illness cases which are developed over time such as mesothelioma or carpel tunnel syndrome which is also known as an ongoing or cumulated trauma injury, you should file the claim when:

  1. You take a leave from your work to visit a doctor relating to the injury or illness
  2. You come to know that your work was responsible for your injury or illness.

The first stage of a worker’s compensation process is sending a notification to the worker’s employer relating to the injury at work or illness caused by work and also filing a formal workers compensation insurance claim. The notification of injury or illness to the employer should include these details:

  1. Date
  2. Time and place of injury
  • How the injury occurred (as detailed as possible)
  1. A list of witnesses (if available and if injury/accident was caused in a specific workplace)

Case: 1

Sharan Kumar was working in J.S Manufacturing facility from the last five years. He was a responsible worker who never took unnecessary leaves and was also very punctual with his work.

Read More: What is the Workmen’s Compensation Act?

However, last Monday, Sharan did not report to the office, and his team manager called him to know the reason. His wife picked up the phone to inform that Sharan felt a pull while moving some containers at the workplace but thought nothing of it until it started getting worse over the weekend.

Now the doctor had told Sharan that he had a potential herniated disc and he should rest until he got fine. Sharan’s manager (who called him) sanctioned his ten days leave over the phone.

Next day, Sharan’s wife visited J.S Manufacturing facility and filled the workmen compensation insurance policy. She gave the complete detail of the accident, like date, time, place of injury, etc. and informed the insurer as well.

As Sharan’s wife timely informed the the workmen compensation insurance company, the latter considered the claim application. As the accident during the working hours, the worker compensation insurance company paid compensation to Sharan.

Here the early communication helped in the timely settlement of the claim.

Case: 2

Rahul Malhotra, a retail sales associate, injured his elbows and legs while hauling clothes at the workplace. As the injury was not looking major, he continued working in the store. In the evening, when he reached his home, he felt great pain in his right elbow which now also became motionless.

As his family had gone to attend a relatives’ marriage, he called his friend, Varun who took him to a private clinic. After a series of X-rays, the doctor found a severe swelling in Rahul’s right elbow and gave him an injection and medicines for some relief. Once the swelling went, the doctor advised Rahul to go for physiotherapy as well.

Read More: Does Premium of Workmen Compensation Policy Changes Every Year? How?

Due to the injury, Rahul had to miss the office for ten days. When after ten days, Rahul re-joined the office, his colleagues asked for the reason of his leaves. Then only he told them about his injury.

Rahul got a major shock when his colleague, Suraj asked him “Did you inform the workmen compensation insurance company?” The thought of informing the insurance company never came in the mind of Rahul in the last ten days who paid all the medical expenses from his pocket.

Rahul rushed to the HR department to fill the workmen compensation insurance form. He also phoned the insurer. However, the insurance company refused to consider it as a workplace injury and rejected the claim due to the delay of 10 days.

As Rahul neither informed anyone about his injury nor registered his claim within a stipulated time-frame, the workers compensation insurance company was right by rejecting his claim.

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