How to File a Workers' Compensation Claim in D.C.
Medical coverage, wage replacement, and disability benefits are available under D.C. workers’ compensation laws, but it’s not always easy to get paid. Knowing how to file a D.C. workers’ comp claim can make a big difference in your ability to access full benefits.
When you’re hurt or sick, getting workers’ compensation should be as simple and stress free as possible. Far too many deserving D.C. workers give up the fight because it gets too overwhelming. That puts an unfair financial burden on them and violates their rights under the law.
Let Trollinger Law LLC take up the fight for you. Workers’ compensation attorney Matt Trollinger can handle every aspect of your claim for you. When you work with us, all you’ll need to do is focus on getting healthy again.
Call for contact us for free consultation now.
Steps to Take After Suffering a Workplace Injury
After a workplace accident, follow these steps to protect your rights:
- Tell your employer. Under the District of Columbia’s workers’ comp laws, you must promptly report that you were hurt in a work-related accident to your employer and the D.C. Office of Workers’ Compensation within 30 days of the accident or the date you became aware of the injury. Otherwise, you might lose your right to benefits.
- See a doctor. It’s critical to have a medical professional evaluate your injury or illness right away. This helps you heal as quickly as possible and reduces the risk that the accident will cause you long-term harm. The doctor’s report will also serve as an essential piece of evidence for your workers’ comp claim. Without a thorough medical report, the insurance might company might deny your claim or offer you much less than you deserve.
- D.C. workers’ compensation laws allow employees to choose their own doctor. However, once you choose a doctor, you usually can’t change to another physician without first getting approval from the Office of Workers’ Compensation or your employer’s insurer.
- Collect evidence. Workers’ compensation benefits are also known as no-fault benefits. That’s because you don’t have to prove that that employer was negligent in order to receive them. However, it’s helpful to gather as much proof as possible in case the insurance company rejects your claim. Examples include photos, video of the accident scene, and witness statements. Collect this information even if your employer already knows about the workplace accident.
- Evidence is also crucial because you may be entitled to file a lawsuit if a third party (not your employer) caused the accident. Your ability to sue will depend entirely on the facts of your case. For this reason, it’s a good idea to talk with an experienced injury lawyer who can identify if someone else can be held liable.
- Talk to a skilled D.C. workers’ compensation attorney. Your ability to collect workers’ compensation in D.C. will hinge on submitting a strong claim with solid evidence. It also means meeting every deadline and filing the correct forms with the Office of Workers’ Compensation. A knowledgeable Washington, D.C. workers’ compensation lawyer can guide you so that no detail is overlooked on the path to benefits. An attorney will also know to look for alternative sources of compensation for you, such as through a third-party lawsuit.
Tips for Obtaining Workers’ Comp Benefits
To get the full workers’ compensation benefits you’re owed, you must suffer from a qualifying injury or illness. D.C. law requires employers to cover most work-related accidents, including injuries from a single accident, illnesses from repeated exposure to a harmful substance, or injuries developed from a routine job duty. The most important element that determines your right to workers’ comp is proving your injury was work-related.
It’s important to submit a complete and convincing claim that clearly explain how your injury or illness has affected your life and your ability to perform your job. Otherwise, the insurer might deny your request for full benefits.
No matter where your injury occurred, it may be covered by workers’ compensation as long as it happened while you were performing job duties. For example, if you are injured in a car wreck while you’re driving to deliver an item for your employer, then you are typically eligible for workers’ compensation.
However, if the accident happened while you were off the clock, such as while you were commuting to work, then you likely are not entitled to benefits.
Additionally, you might not be eligible for benefits if you purposely injured yourself or did something illegal that contributed to your accident, such as driving while intoxicated.
Another tip to protect your claim for benefits is to follow your doctor’s orders exactly as prescribed. If the insurance company learns that you’re not attending your physical therapy appointments or filling your prescription medications, it will be much more difficult to get the best possible outcome for your case.
Types of D.C. Workers’ Compensation Benefits
Under the District’s workers’ comp laws, employees suffering from workplace injuries or illnesses are eligible to receive benefits to cover a range of expenses and losses, such as:
- Medical bills: Workers’ comp covers any medical treatment needed for you to recover from your workplace injury or illness. This includes expenses like hospitalization, medications, other treatments, visits with your doctor, and specialized medical devices. This benefit also covers your cost to travel to and from medical appointments related to the accident.
- Lost wages: If you are able to perform some type of work during your recovery, then workers’ comp covers up to two-thirds of the difference in wages between this work and your previous job for a maximum of 260 weeks.However, if you are unable to work at all, temporary disability benefits help cover two-thirds of your average weekly wage during the period that you’re unable to work, up to certain limits on wages and the number of weeks covered.
- Disability: Once you max out your temporary disability benefits, you might be eligible for additional wage replacement if your accident leaves you with permanent and total disabilities that prevent you from doing any sort of job. Wage replacement benefits for permanent total disabilities typically cover up to two-thirds of your average weekly wage for as long as your disability continues.
If your accident leaves you with a permanent disability, but you are still able to work, then you might be eligible for permanent partial disability benefits. Depending on the injury and disability rating you receive, you might be entitled to a lump sum payment, as well as partial wage replacement.
How to File a Workers’ Comp Claim in D.C.
Once you inform your employer about your work-related injuries or illness, the next step is to tell the DC Office of Workers’ Compensation within 30 days and complete Form 7. This is D.C.’s form for “Employee’s Notice of Accidental Injury or Occupational Disease.” You must submit Form 7 to the workers’ comp office and give a copy to your employer.
In addition, you must file a workers’ comp claim (Form 7A) with the Office of Workers’ Compensation within one year of the accident. You can get both Form 7 and Form 7A from your employer, the Office of Workers’ Compensation, or your employer’s insurer.
Once your employer receives Form 7, they should file an “Employer’s First Report of Injury or Occupational Disease” form. Their insurer must review the claim, and within 14 days, they must either send you a denial or start paying your workers’ comp benefits.
Denial of Workers’ Compensation Claim Appeals
If insurance denies your workers’ comp claim, then you have a right to file an appeal with the Office of Workers’ Compensation. This appeal typically involves a hearing, where you and your employer present evidence and arguments about your injuries and the amount of benefits you deserve. An administrative law judge will listen to the evidence and issue a binding decision. If you still disagree, you can appeal to the Compensation Review Board.
If you’ve reached the appeals stage of a workers’ compensation case, Trollinger Law LLC highly recommends that you seek a lawyer’s help. These hearings are formal proceedings and will require that you follow strict procedures. An attorney can prepare your claim and prevent small errors that could cause your claim to be dismissed.
How a D.C. Workers’ Compensation Lawyer Can Help
The best time to contact a lawyer is right after you suffer from a workplace injury or are diagnosed with a job-related illness. An attorney can handle every part of your case, including collecting the evidence and filing all of the paperwork required to get the process underway.
In addition, a dedicated lawyer can handle all disputes with your employer and its workers’ comp insurer so that you aren’t overburdened while you heal. If needed, an experienced DC workers’ compensation lawyer can also guide you through every stage of the appeals process.
Get a D.C. Workers’ Compensation Attorney On Your Side
If you are suffering from a workplace injury or illness, Trollinger Law LLC is here to stand by your side and fight for the compensation you’re owed. Schedule your free consultation by calling or contacting us today.