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Understanding the claims process

Insurance can be a useful tool for protecting against risks of many kinds. Workers’ compensation insurance helps protect and compensate employees who have sustained covered injuries while completing work-related tasks. In the event an accident occurs, it is important that the insurance policyholder is proactive and notifies the insurance company or files a claim.

With health insurance, the claim process mostly happens behind the scenes. The hospital or doctor’s office will contact the insurance company and file the claims on behalf of the patient. However, with workers’ compensation insurance, the process is a little different.

Workers’ comp payments kick in only after an accident or injury has occurred, so it is important that both the business owner and the employee are proactive about documenting everything related to the incident and filing the appropriate paperwork. This usually means filling out an accident report or similar document—even before an insurance claim is filed.

The business owner should know how to file for workers’ comp on behalf of their employees. If the business owner has any questions about this, they should contact their workers’ insurance company for guidance.

How to file workers’ compensation claims

Before an injury compensation claim is filed, the supervisor and employee should work together to collect as much documentation about the accident or injury as possible. The more information about the incident, the better. Without proper documentation and solid proof that the injury occurred on the job, the claim may be denied.

Some helpful types of evidence to include might be:

  • Photographs of the injury
  • Photographs of any damaged or faulty equipment
  • Timesheets
  • Video of the incident (e.g., from a security camera)
  • Vehicle logs

It is important to prove that the employee was on the clock (i.e., punched in) and in the act of completing work-related duties while the accident took place.

Documenting a work-induced illness is a little more difficult. For example, a mold abatement specialist that comes down with a respiratory illness after spending two months on the job will have to prove that their respiratory illness was caused by workplace exposure. For instance, they may need to provide documentation such as:

  • Medical records before and after the onset of the illness
  • Photographs of insufficient protective gear, if applicable
  • Evidence of any pre-existing conditions (or lack thereof)

Receiving workers’ comp benefits for a chronic illness or injury, such as carpal tunnel syndrome, is a relevant work related injury, and should be pursued if the employee is certain that their work-related duties caused it.

Explore the Claims Process

Read this step-by-step guide about what happens after CompSource Mutual is notified of a workplace injury.

Filing a work injury claim quickly

Time is also a factor in understanding how to file workers’ compensation claims. It is important that the documentation and accident report are submitted to the business owner or supervisor right away. If an employee waits to notify their employer about the accident, the claim may be denied.

In addition to the documentation and accident report, the employer should also be prepared to send additional information to the insurance company, such as:

  • Whether the employee missed time from work due to the injury/illness
  • If the employee went somewhere for treatment, and the address and/or phone number of the treatment facility
  • If there were any witnesses
  • If the witnesses filled out a witness report
  • Whether light duty is available to the employee

(“Light duty” is a modified version of the job the injured or ill employee was doing before the incident.)

Acting on a workplace injury is also important for the safety of other employees. If the accident occurred due to faulty equipment or a hazardous situation, the supervisor should act right away to make sure these risks are under control and cannot harm other employees. If possible, the supervisor should immediately determine how the accident happened, and try their best to ensure it doesn’t happen to other employees at that worksite.

Why CompSource Mutual

At CompSource Mutual, employee safety is our top priority because we believe that Oklahoma’s greatest asset is its people. If you don’t know how to file workers’ compensation claims, we can help you navigate the process. Contact us to file a claim early, as we have a robust network of resources available to support your workers and your business in the event of a covered workplace injury.

We’ve been supporting Oklahoman businesses for more than 85 years. As the Sooner State’s long-standing Oklahoma insurance provider, CompSource Mutual is uniquely qualified to offer top-notch workers’ comp protection to businesses at a fair price.

Injured Worker Coverage

Check out our coverage details and benefits for CompSource Mutual policy holders and injured workers.

Although carpal tunnel is a common injury that may be caused by non-workplace circumstances, it can be covered by workers’ compensation. If an employee develops carpal tunnel, workers’ comp insurance can provide payments for medical bills and treatments for it. The employee, however, must prove that the carpal tunnel was directly caused by work-related duties.

Filing workers’ compensation claims can be tricky. Therefore, the process should be guided by a trusted partner, such as CompSource Mutual. If the business owner or supervisor is not aware of the claims process, they can call their insurance provider, and a representative should be able to walk them through the process over the phone or via email. Insurance companies will often have resources online to help with understanding this process as well.

Calculating workers’ comp premiums is the same for any business, large or small. The insurance company typically uses a formula that includes the business “class code,” or job type; their workers’ compensation modification rate; and the business’ total payroll.

Yes, it does. An impairment rating is a quantifiable way of determining how severe an employee’s injury or illness is. It only applies to permanent impairments. An impairment rating is supposed to apply on a “whole-person” level, indicating how much the injury or illness has impacted the employee’s life and ability to work. A more severe workers’ comp impairment rating will result in a higher payout.

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