When an employee is injured, they may file a workers’ compensation claim against their employer. The employer may also file a workers’ compensation claim against the insurance company in some cases. This article will discuss the differences between employees and employers filing workers’ compensation claims.
Employee Filing
When an employee files a workers ‘ compensation claim, they typically file against their employer. The employee will need to prove that they were injured and that their work caused the injury. The employee may also need to provide medical records and other evidence to support their claim.
The process of an employee filing a claim begins with the employee filing a form called the “Worker’s Report of Injury”. This form provides information about the injury and is usually filed with the Industrial Commission of Arizona (ICA). The ICA will then send the paperwork to an assigned claims examiner who gathers evidence, interviews witnesses, and evaluates whether or not an injury occurred. If they determine that an injury did not happen, the employee may request reconsideration. If an injury did occur, they would then send a Notice of Benefit Determination (NOD) to the employer and employee. This NOD will state the amount of
- coverage,
- benefits, and
- conditions;
That must be met for the employee to keep their benefits. An employee can file an objection if they disagree with the NOD. The employer may also file a Notice of Contest, which will initiate a hearing and subsequent appeal process.
Employer Filing
When an employer files a workers’ compensation claim, they typically file against the insurance company. The employer will need to prove that the employee was injured and that their work caused the injury. The employer may also need to provide medical records and other evidence to support their claim.
The process of an employer filing a claim is similar to that of an employee filing a claim. The employer will file an “Employer’s Report of Injury” form and send medical records and evidence supporting their claim. If they are denied, they may request reconsideration. It is crucial to ensure that the correct party is filing when filing a claim. If an employer attempts to file for employee benefits or vice versa, this mistake could jeopardize the entire process. It may also lead to penalties and fines, which will need to be paid back by the person who initially filed incorrectly.
As with all claims, the onus is on the employee to prove that they are entitled to benefits. The onus will be on the employer filing for their own business.
If you need help with a workers compensation claim, contact Phoenix Workers’ Compensation Attorneys for a free consultation. Though the process of filing a workers’ compensation claim is typically straightforward, there are a few things that you should keep in mind. When an employee files a claim, they generally go against their employer. The onus will be on the employee to prove that they are entitled to benefits. Conversely, when the employer files a claim, they typically go against the insurance company.
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