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How To Make a Workers’ Compensation Claim in 5 Easy Steps
Employers need to follow a few steps when filing workers' compensation claims. The process begins when an injured worker reports an incident, completes the required forms and seeks medical care.
Workers’ compensation insurance, also known as workers’ comp, is an important coverage to have because it can help your employees recover from work-related injuries or illnesses.
If one of your employees tells you they got sick or injured from their work, it’s important to file a workers’ compensation claim with your insurer right away.
1. Your Employee Reports an Injury or Illness
The first step of the workers’ compensation claim process begins with your employee notifying you (the employer) of a workplace injury or illness. The time an employee must provide written notice of a workplace injury will vary in each state and can range from a few days to up to a year or more. Regardless of the timeline set by your state laws, you should educate and train your employees to report workplace injuries as soon as possible.
Some workplace injuries, like slipping on a wet floor and breaking an arm, may require immediate medical treatment at an emergency room. While other injuries or illnesses that happen on the job may require a doctor’s visit for diagnosis.
2. Give Your Employee a Workers’ Comp Claim Form
If you’re told someone got hurt or sick from their job, make sure they get appropriate medical care. You’ll also want to give your employee a claim form to complete so they can apply for workers’ compensation benefits. The employee should fill out the form and return it to you. Only the employer can submit the workers’ comp claim form. Without a completed form, your employee can’t get workers’ compensation benefits that could help them recover and return to work.
In some states, you may also need your employee to fill out a First Report of Injury form that you’ll need to submit to your state’s workers’ compensation board. Keep in mind that the forms you need to fill out often will depend on where you and your employees are located, what type of injury or illness occurred and who your insurance provider is.
3. Submit Official Claim Paperwork
After your employee provides a completed form, you’ll need to file a workers' compensation claim with your insurance company. This notifies your insurance carrier that a new claim is ready to be processed.
Be sure you understand how to file workers’ comp according to your state laws. Every state has a time limit to file a workers’ compensation claim. For example, New York employers have to file a claim within 10 days of an accident. In most cases, the employer is responsible for submitting the claim form and any supporting documentation, but your employee’s doctor may also need to submit a medical report, too.
Depending on what state you’re in, you may be required to report the injury to your state’s division of workers’ compensation or the state’s workers’ compensation board.
4. The Workers' Compensation Claim Is Either Approved or Denied
Your insurance provider will either approve or deny your claim once it’s been submitted and reviewed. If the claim is approved, your insurer will inform you (the employer) and contact your employee with payment details. The employee can either accept insurance company’s offer consisting of medical bills, medicine, disability payments and a portion of lost wages, or they can negotiate for a lump-sum settlement or larger structured settlement.
If the claim is denied, your employee can request a reconsideration from the insurance provider or file a formal appeal through their state’s workers’ compensation board.
5. Provide Accommodations When Your Employee Returns to Work
Depending on the injury or illness, you may need to make changes to help your employee do their job when they return to work. In some cases, you may have to train them to perform a new role.
Even if your insurance carrier decides to deny the claim, your employee can dispute their workers’ compensation benefits or file an appeal. Check your state’s claims process for workers’ compensation cases so you know what to expect.
Workers’ Comp Employer Obligations and Best Practices
It’s important to make sure your business is following your state’s workers’ compensation laws. Failing to meet your workers’ comp employer obligations can result in expensive fines and other penalties against your business. Be sure to follow these best practices:
- Provide employees with up-to-date information about their rights and workers’ comp benefits.
- Invest in training around workplace safety and how and when to report workplace injuries.
- Incorporate workers’ compensation benefits and training into employee onboarding.
- Report injuries within the appropriate state timelines.
Common Questions About the Workers’ Compensation Claims Process
With different rules by state, workers’ compensation insurance for small businesses can get complicated. We’re here to help simplify it with answers to common workers’ compensation insurance questions.
When Do I File a Workers’ Compensation Claim?
You should report injuries or illnesses if the person:
- Is your employee
- Got hurt while performing their job
- Becomes sick from their work
If you don’t file a workers’ compensation claim on time, your employee may not get benefits.
What Qualifies as a Workers’ Comp Claim?
Most work-related injuries qualify for workers’ compensation benefits. Some examples might include:
- Illness from exposure to hazardous materials in the workplace
- Broken bones from a fall on slippery office floors
- Repetitive stress injuries, such as carpal tunnel syndrome
In some cases, your employee may need urgent treatment. For non-emergencies, your insurance company may require the employee to seek medical care from an in-network provider in order to receive workers’ compensation benefits.
What Information Do I Need To File a Workers’ Compensation Claim?
When you file a workers’ compensation claim with your insurance company, you’ll need to include your:
- Account number and location code (if applicable)
- Parent company name (or program name)
- Policy number
It’s also important to send your injured worker’s information, such as their:
- Name, date of birth, address, phone number
- Social Security number
- Age and gender
- Marital status, number of dependents
- Hire date, years in current position
- Current wage information
Your claim form should include as many details of the incident as possible, such as:
- Date and time of the incident
- When you received a report of the injury or illness
- Who reported the accident and when
- Where the injury or illness occurred on your business property
- Type of injury or illness
- Exact body part injured
- Witness information
- Cause of accident
- Name and location of where your employee received medical care
- Number of days your injured worker will miss work
- Anticipated return to work date
Where Can I Find My Workers’ Comp Phone Number?
Your workers’ comp policy should include a phone number or other contact information for your insurance carrier. If you have a policy with The Hartford, you can file a workers' comp claim online. If you need help to file a workers’ compensation claim, call 800-327-3636.
How Do I Know if My Employee’s Workers’ Comp Claim Is Approved?
After you file a workers’ compensation claim, your insurance company will notify you and your employee if they approve the claim. Your employee will work with your insurance carrier to receive reimbursements for medical treatment or other benefits.
Can I Pay Workers’ Compensation Claims Out of Pocket?
If your state requires businesses to carry workers’ comp insurance and you don’t have coverage, you’re responsible for paying for your injured worker’s medical treatment and other costs they may incur. You also may face penalties and fines from your state’s workers’ compensation board.
Last Updated: February 20, 2025
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