Step By Step Guide to Filing a Workers’ Compensation Claim in Washington, D.C.

The office of the District of Columbia workers’ compensation has created an easy process to submit the necessary documents when an employee of a company is involved in a workplace accident or injury. The workers’ compensation process was established due to some employers treating their employees poorly and putting them in grave danger. This type of treatment includes poor working facilities, lack of personal protective equipment, inadequate working gear, poor working area, and low compensation or wages, to name a few.

Millions of workers are involved in accidents every year. A serious injury can cause a great disruption in workers’ life. Workers’ compensation claims will help mitigate employee loss after reporting the incident. An injured employee can get medical coverage and financial assistance for lost income through these insurance programs. If you need assistance, don’t hesitate to contact us for a free consultation.

District of Columbia Workers’ Compensation Insurance

In D.C., Workers’ compensation insurance is mandatory for every employee, including part-time workers, if the employer has 1 or more employees. In order to be considered an employee, you must be a regular employee. If you are an independent contractor, gig worker, or volunteer, you likely won’t be eligible for workers’ compensation insurance.  

What Does Workers’ Compensation Insurance Cover?

Workers’ compensation benefits can cover medical and hospital expenses. It can also provide partial wage replacement if the employee cannot work. Workers’ compensation insurance in the District of Columbia typically covers the following:

  • Medical benefits to pay for medical treatment, including surgery and prescription medications
  • Some travel for medical procedures or appointments
  • Loss of earning capacity 
  • Compensation for lost or damaged property
  • Job retraining and help in finding work after an injury
  • Emergency treatment
  • Follow up care

D.C. Workers’ Compensation Won’t Cover the Following:

  • Stress or other mental injuries
  • Self-inflicted injuries
  • Injuries caused by fighting
  • Injuries that happen while commuting to or from work
  • Injuries sustained while violating company policies

When To File a Workers’ Compensation Claim

Getting injured on the job or within the scope of employment qualifies you for workers’ compensation benefits. This injury can occur due to exposure to harmful chemicals or any form of occupational illness or accident while on the job.

Before an employee is qualified to file a claim, the following criteria must be true:

  • There is an active workers’ compensation policy
  • The injured employee is eligible.
  • The injury or illness occurred at work or occurred due to work conditions.

Filing for Workers’ Compensation In D.C.

After an Injury at a workplace, reporting the incident is the first step in the Workers’ Compensation claim process. You will need to complete the DCWC From 7, Employee’s Notice of Accidental Injury or Occupational Disease with your employer and The Office of Workers’ Compensation Commission. This must be done within 30 days of the date of your injury or the date that you become aware that the injury is related to your job. 

In order to make sure you are entitled to benefits, you must also file a written claim on DCWC Form 7a, Employee’s Claim Application, within 1 year of your injury.

In addition to reporting your injury and filing a claim, there are other steps you should take after an injury or illness that occurs at work. Consider taking the following steps:

Seek Emergency Medical Attention Right Away

If you were injured on the job anywhere in the District of Columbia, the first thing to do is seek immediate medical attention. It is important to get a medical evaluation by a professional to ascertain the degree of the injury. Your benefits will depend on the extent of your injury and treatment needed, so take notes and collect all medical records and expenses.

Collect Evidence

After an injury, gather as much evidence as possible about your injury, including how and where it occurred, why it occurred, and anything else that could be relevant to showing what happened. While workers’ compensation benefits are provided on a no-fault basis, meaning you are entitled to these benefits even if your employer wasn’t negligent, it’s still helpful to provide as much evidence and context as possible to ensure that your claim is processed properly and in a timely manner. This can include photos, video footage, and witness statements. It’s not uncommon for a workers’ compensation insurance company to try to deny paying out benefits, so the more information you can provide, the better. 

Reasons for Workers’ Comp Denials

Filing a claim doesn’t mean you will be compensated; sometimes your claim will be denied, even if you think it shouldn’t be. Common explanations for a denial of benefits include the following:

No Workplace Injury

If the insurance company believes that your injury didn’t occur at work or during the scope and course of your employment, they will deny your claim. If you were injured on your lunch break, you may be out of luck.

Failing to Report your Injury

One of the most common reasons that a workers’ compensation claim is denied is failing to report the injury to an employer on time. If you don’t report the injury to your employer within 30 days, your claim could be denied. 

You Were Under the Influence

If you were injured at work while you were under the influence of alcohol or drugs, you will be denied benefits if your employer or the insurance company knows this fact. If you are injured and are taken to the hospital right away, you could be tested for alcohol and drugs. If this happens, your employer has the right to know what the results are. 

Your Injury Was Due to a Pre-Existing Condition

If your injury was a result of a pre-existing condition that employment did not worsen, your claim will be denied. This doesn’t mean that anyone with a pre-existing condition isn’t entitled to benefits. It just means it will be more difficult and you will need more evidence proving that your employment actually worsened your injury.

Why Should You Contact a Workers’ Compensation Attorney?

The process of filing a claim might seem very easy, but it can be quite nuanced, and most insurance companies will do whatever it takes to deny claims so they don’t have to pay out benefits. An experienced Washington D.C. workers’ compensation lawyer will help your case in numerous ways, such as providing legal guidance and advice, gathering evidence supporting your claim, negotiating with the insurance company, and helping build your workplace accident case. If your claim is denied, having an experienced workers’ compensation lawyer will be incredibly helpful.

If you need help with a workers’ compensation claim in Washington D.C., don’t hesitate to contact us today for a free consultation.