How Long Does It Usually Take to Get Workers’ Compensation?

One of the first questions we hear from new workers’ compensation clients is, “How long does it take to get workers’ compensation benefits in Tennessee?” This is normal—when your paycheck stops and your expenses do not, you want to get your wage replacement checks coming in as quickly as possible. The answer is not the same for every case, and there are numerous factors at play, but knowing generally what to expect from this process can help you plan.

At Rocky McElhaney Law Firm, we advocate for workers who are denied the benefits they are owed under state law. Call us today to schedule a consultation.

Initial reporting and claim filing

The timing of a workers’ compensation claim is very important. If you wait too long, you can lose your right to workers’ compensation. In Tennessee, you generally must notify your employer within 15 days of the injury or when a doctor first tells you it is work-related, and you usually have one year to file a petition for benefit determination with the Bureau. However, you should not wait that long. In fact, you should report the injury to your employer as soon as it happens or as soon as you become aware of it. The longer you wait to report, the harder it is to prove your injury and to show that it was caused by your work.

Once you inform your employer of your injury, they must submit a report to their workers’ comp insurance provider within one working day.

Claim review leading to approval or denial

The workers’ comp insurance company then has time to decide whether or not they are going to cover the claim and if they consider it valid. However, that does not mean that you wait to treat your injury until then. You should get your injury checked out immediately after it occurs and act as if your claim will be approved. This may mean seeing approved providers rather than your own doctor. Delaying medical care can actually cause your workers’ compensation claim to be delayed or denied—you are expected to follow your care provider’s treatment plan to the letter.

After you notify your workplace of your injury, the insurance company must decide whether your claim is covered and compensable within 15 calendar days, and you must be notified of that decision within the same 15-day period.

Payment of benefits

If your claim is approved, you are entitled to partial wage replacement benefits. Temporary disability benefits are paid by the insurance company when you are temporarily out of work. You are not paid wage replacement benefits for the first seven days of disability. Benefits begin on the eighth day, and if your disability lasts at least 14 days, you are then back-paid for the first seven days. Note that payments are not always paid on the same schedule or in the same way as your regular income. Your payments may be sent by the insurance company or by your employer. If your injury is deemed compensable and you are taken off work, your temporary disability payments must begin no later than 15 calendar days after your disability begins.

Case complexity and settlement

Workers’ compensation usually ends when the worker makes a full recovery and is able to return to their standard work schedule and workload. At that point, you begin receiving your normal wages, and your disability benefits end. Not everyone is lucky enough to make a full recovery, though. If your injury is permanent or long-term, the company is likely to attempt to negotiate a settlement. This allows them to pay you one lump sum rather than continue to pay disability benefits with no end in sight.

The process of negotiating a settlement can take months, with more complex cases lasting a year or more. This is where it is very important to have a workers’ compensation lawyer advocating for you. The insurance company will attempt to pay you as little as they can to settle your claim and close the case. However, it is very likely that their initial offer will not actually be enough to make up for your loss of income and the medical care you will need. A workers’ compensation attorney can evaluate your case, determine the extent of your financial losses, and ensure that you only consider offers that are fair to you.

Factors affecting your timeline

No two claims are the same, and there are some factors that may delay your workers’ comp claim. These factors include:

• Severe or complex injuries: The more severe your injury is, the harder it can be for an insurance company to determine whether or not it is work-related.
• Disputes regarding the origin of the injury: If the insurance company or your employer believes the injury may not be work-related, this can significantly delay the claim.
• Requests for additional records or an independent medical examination: Should the insurance company want an independent medical examination or need additional records to prove the injury, your benefits may be delayed.
• Missing documentation: Missing documentation on wages, work restrictions, and the cause of your injury can also cause the insurance company to hold off until they get the proof they need.

In many cases, delays are the result of administrative issues or common problems. But when they’re the result of an insurance company delaying a claim in bad faith, it may be time to bring in an attorney and advocate for yourself.

Explore your rights under workers’ compensation law with Rocky McElhaney Law Firm

If you have suffered a work-related injury and your employer is delaying your workers’ comp benefits, it is time to talk to an attorney who can fight for you. Call us today or contact us online to set up a consultation now.