Filing a Workers’ Comp Claim Step by Step
Workers’ compensation pays for medical care and part of your lost wages after a work injury or illness, no matter who was at fault. Each state runs its own system, but the steps are similar everywhere, and missing a deadline can cost you your benefits.
- All workers
- Texas
Photo: injured worker filling out a claim form with a supervisor
Step 1: Get medical care
- In an emergency, call 911 or go to the nearest emergency room.
- Tell every doctor and nurse that the injury happened at work, and describe exactly how.
- In some states your employer or its insurer picks the doctor or a network, at least at first. Ask which doctors you can use, but don’t delay emergency care to find out.
Step 2: Report the injury to your employer
- Tell your supervisor right away, the same day if you can, even if it seems minor. Back injuries and repetitive strain often get worse over days.
- Put it in writing: a text or email with the date, time, place, what happened and what hurts. Keep a copy.
- State deadlines to report are often 30 days, and some are shorter. For an illness like hearing loss or a lung disease, the clock usually starts when you learn it’s work-related.
Step 3: File the claim form
- Your employer should give you the state’s claim form or file a first report of injury with the insurance company.
- In some states you must also file a claim with the state workers’ comp agency. Deadlines are often 1 to 2 years from the injury, and sometimes shorter.
- If your employer won’t give you a form or report the injury, contact your state workers’ comp agency directly.
Step 4: Follow up on benefits
| Benefit | What it usually covers |
|---|---|
| Medical care | Doctor visits, hospital, surgery, prescriptions, therapy; usually no copay |
| Temporary disability | Often about two-thirds of your average weekly wage, up to a state maximum, while you can’t work. Most states have a waiting period of 3 to 7 days, paid back if you’re out long enough. |
| Permanent disability | Payment for lasting damage, like lost use of a hand or hearing |
| Job retraining | Help in some states if you can’t return to your old job |
| Death benefits | Payments to dependents and help with funeral costs |
Keep a claim file
- Claim number, insurance company and adjuster’s name and phone
- Copies of every form, letter and doctor’s note
- A log of calls: date, who you spoke with and what they said
- Your work restrictions in writing from the doctor
- Pay stubs from before the injury (to check your average weekly wage)
- Mileage to medical appointments (many states reimburse it)
- Names of coworkers who saw the injury
Mistakes to avoid
- Waiting to report because you hope it gets better
- Telling the doctor it happened at home, or not mentioning work
- Missing appointments or ignoring work restrictions
- Posting about your activities on social media during your claim
- Signing a settlement or release without understanding it
Retaliation is illegal. You can’t be fired or punished for reporting an injury or filing a claim. A few employers in some states, like non-subscribers in Texas, don’t carry comp insurance; you may be able to sue them instead. See Workers’ Compensation.
Standards & references
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