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What Happens if an Employer Does Not Report an Accident to Workers’ Comp?

Written by Ankin Law Office

If an employer does not report an injury to its workers’ compensation insurer, it could face penalties and be sued in court. Meanwhile, the worker could apply for and receive benefits that are retroactive to the injury date. Whenever an employee misses more than three days of work due to a work injury, the employer must report it. The report must go to either the Illinois Workers Compensation Commission (IWCC)or the respective workers’ compensation insurance underwriter. The insurer in turn must report the accident to the IWCC.

When the employer does not file a valid workers’ compensation insurance claim, the affected worker should notify a supervisor or human resources. If that does not result in a filing, then experienced Chicago workers’ compensation lawyers might have to get involved.

Consequences of Not Filing Workers’ Comp Claims

When a workers’ comp claim is not filed in a timely manner, the worker could suffer significant financial harm. The worker’s compensation insurer is more likely to deny late claims than it is timely ones that are filed right away. Workers have up to 45 days following a work accident to report injuries and seek workers’ compensation benefits.

Any worker who suffers an injury while working and misses more than three days of work initially qualifies for workers’ compensation coverage. The process to obtain those benefits is simple:

  • Obtain medical treatment right away to document injuries.
  • Notify the employer.
  • Provide a doctor’s note that includes the injury diagnosis.
  • Request workers’ compensation benefits.

Once the worker completes that simple process, the workers’ compensation benefits should begin no more than 14 days after the injury date. But if the worker does not report it, the worker cannot obtain the benefits.

The worker also might negate any chance of having personal health insurance coverage pay for medical costs. Private health insurers, Medicaid, and Medicare require work-related injuries to be covered by workers’ compensation. If the worker files a health insurance claim for injuries obtained at work, the health insurer could deny the claim.

What if an Employer Refuses to File a Workers’ Comp Claim?

An employer is not allowed to determine whether a workers’ comp claim should be filed. The insurer looks at the filing and supporting evidence. If the insurer is unsure whether the claim qualifies for benefits, it could assign the matter to an insurance adjuster to look into it.

An employer might not carry state-mandated workers’ compensation coverage. An employer might routinely refuse to file workers’ compensation claims. If so, the workers could file legal claims against the employer.

One of the ways in which worker’s comp protects employers as well as injured workers is by removing the right to sue from workers who accept worker’s comp benefits. But if the employer does not have insurance coverage or refuses to file a valid claim, that worker could sue the employer.

If enough workers file lawsuits for generally similar reasons, it might lead to a class action lawsuit against employer negligence. A well-supported class action against an employer could carry a great deal of legal weight. It also could help many affected workers to obtain their due benefits.

What if an Employee Did Not Report Injury in a Timely Manner?

When an employee is injured, the question of what happens if an employee does not report an accident to workers’ comp could arise. If the worker neglects to notify the employer of the workplace accident and resulting injuries, the employer cannot file a worker’s comp claim. That means the worker could not obtain benefits for any missed time from work or to pay for medical costs.

Any delays in reporting a workplace injury to the employer weaken a worker’s claims for work-related injuries. That worker could be denied workers’ compensation coverage. The worker also would have a hard time pressing any claims in a lawsuit.

An injured worker is obligated to report the injury to the employer. But the worker needs to do so as soon as possible. Obtaining medical attention for any injuries suffered always is the top priority. But, if possible, the employer should be notified either before leaving to get medical treatment or immediately afterward.

The employer should complete an incident report regarding the workplace accident and its causes. The worker needs to provide a doctor’s note that generally details the injuries suffered. The incident report and medical confirmation of injuries should be enough to obtain workers’ compensation benefits.

Injured Workers Could Lose the Right to Sue

If an injured worker does not seek treatment or report the matter as soon as possible, that worker could lose more than workers’ compensation benefits. Any delay in reporting an accident and resulting injury raises doubt about the validity of an eventual worker’s compensation claim.

That same doubt would make it more difficult to file any legal claims against the employer. The worker could file a lawsuit, but an experienced workers’ comp attorney representing the employer might get it thrown out due to a lack of merit.

Some injuries truly are delayed and take time to manifest themselves. The same could apply to a work-related illness. But whenever an accident happens that might result in injury, the worker has the burden of reporting it as soon as possible.

Requirements for Reporting Workers’ Comp Claims

Illinois law requires employers to carry workers’ compensation insurance to protect workers and employers against workplace injury accidents. Workers’ comp protects workers against the costs of suffering injuries while working and helps them to keep their jobs. The insurance also protects employers by making any worker who accepts it ineligible to seek damages in a civil lawsuit.

The IWCC requires that the worker’s employer file an accident report with the commission within a month of the accident date. If the employer does not file a report, the insurer underwriting the workers’ compensation insurance policy could do it. Many insurers often handle the IWCC reporting requirement.