It is seven o’clock on a Saturday night, and the restaurant is buzzing. A nearly two-hour wait puts pressure on everyone to move faster to expedite orders. Fast sometimes equals personal injury at busy restaurants. As a waiter, there are a number of factors that can cause cuts, burns, scrapes, and broken bones. From a wet kitchen floor to a scalding hot plate warmer, you can get hurt on the job, as well as become ill because of exposure to a sick guest or employee. States have implemented a form of insurance called workers’ compensation to help employers pay for the cost of taking care of employees that become sick or hurt on the job. Workers’ compensation operates like most insurance plans. Your insurance company assesses risk, and your employer pays a premium. In addition to lost wages, workers’ compensation also covers the cost of work-related medical bills. Know what to Do Before Filing a Claim Nearly every state requires employees to notify employers concerning an injury or an occupational illness. Each state has established a deadline for when employees must inform their employers about a work-related sickness or injury. The deadline typically runs 30 days, but you should verify the deadline set by your state. Despite a relatively lenient deadline, you should report a work-related illness or injury right after an incident happens. The longer you wait to tell your employer, the more questionable your claim becomes. You should also seek medical attention immediately after a workplace accident, even if your illness or injury does not warrant emergency care. Filing Your Claim After informing your employer and seeking medical care, the time has come for your employer to hand you the forms required to process a workers’ compensation claim. Although the local workers’ compensation office can provide assistance to ensure the forms you complete are accurate, a state licensed workers’ compensation attorney is the better option to boost the chances of your employer’s insurance company approving your claim. After filling out all the required forms, you give the forms back to your employer for submission. Some states require employees to file a separate workers’ compensation claim with the appropriate state agency. What Happens after You File a Claim? Now, the waiting game begins. Your employer’s insurance company conducts a thorough investigation that includes interviewing some, if not all of the eyewitnesses mention in your claim. Insurers hire the most determined and highly skilled investigators to prevent fraudulent claims from costing their clients money. However, there are other reasons why your company’s insurer can deny your claim. One of the most convincing rebuttals of a workers’ compensation claim is to prove the injuries suffered by a worker took place somewhere other than the workplace. This is an especially relevant reason for claims that lack eyewitness accounts and/or include medical documentation that attributes a cause that could not possibly happen in the workplace. You can expect to undergo drug testing, as a vast majority of companies have included a drug testing clause within the workers’ compensation section of the employee manual. Failing a drug test right after an accident is grounds for denying your claim. Can you appeal a decision made by your employer’s insurer? The answer is yes, but you should work with a highly rated workers’ compensation attorney to present the most persuasive arguments. Most attorney earn money by taking a small percentage of a workers’ compensation award, not from the bank accounts of clients. Additional Resources I’m an Injured Waiter. What Should be My WC Claim be Worth? Workers’ Compensation Claims in the Sit-Down Restaurant Industry Hurt Working At Jeremiah’s Italian Ice*
