What is taking so long, and why does it seem impossible to speak with anyone about your claim? Workers compensation is a very slow process anywhere, but it does seem especially slow-moving in Washington DC.
But, working with a Washington DC workers compensation attorney, you can find out why your claim isn’t moving forward. The claim system relies on many moving parts, and often someone may be waiting for a review process to start or finish not knowing that they’re missing documentation.
Instead of being notified of an issue with your claim, the system will reject your claim and move you into appeals. You can already see how this system is more trouble than anyone could imagine.
Who Is Responsible for Approving Your Claim?
At first, your claim will go through your employer’s workers compensation insurance. This insurance coverage is similar to communicating with standard health insurance or even car coverage. You submit a claim with a statement and then wait for them to either accept or reject the claim.
In Washington DC, you can seek help from the DC Department of Employment Services (DOES). They provide resources and mediate disputes. So, if your employer’s insurance is moving too slowly or rejected your claim, you’ll start to work with this DOES.
If you filed your claim immediately after the injury and have a very straightforward case, then you should allow for a few weeks of investigation. The insurance company has the right to review the claim and your medical history.
If this initial investigation takes more than four weeks to contact a lawyer.
If you filed a claim at the very end of your 30-day window and had issues such as seeking second opinions or switching doctors, you can expect the process to take even longer. If a complex investigation takes more than eight weeks, contact a lawyer for assistance.
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Marked Steps in the Claim Process
There are a few major milestones that can help you keep track of how close or far out you are from getting the approval or rejection notice. The first major milestone is that an administrator or representative will contact you.
When an insurance rep reaches out, you need to consider working with a lawyer. You should, and generally must cooperate with them. However, a lawyer can provide guidance on what information to provide to ensure that they have a full view of the situation.
If your representative isn’t answering your calls or hasn’t reached out to you, contact a workers comp attorney.
The next major milestone is the notice of approval or rejection. Usually, they mail these letters, but you should receive this around four weeks after you started your claim.
If you receive a rejection notice, you’ll need to start your appeal and move into dealing with DOES. However, if you received no notice, speak with an attorney, and they should help you find out if something is causing a hold up in your claim.
Find the Right Washington DC Workers Compensation Lawyer for You
In general, if your claim has taken more than four weeks to process it’s taking too long. Claims get lost, overlooked, and in many instances, insurance representatives are simply overwhelmed with work. That’s not an excuse. It’s just a realistic observation into the insurance industry. You shouldn’t need to wait this long for a claim to go through the system.
Work with a worker’s comp attorney to find out what is causing the issue and how you can get your claim moving again. In some situations, your claim may have missing paperwork or incomplete notes from your doctor. These issues often lead to rejection when a simple call to your doctor’s office could have resolved the problem.
In cases of rejection, you can work with Ashcraft and Gerel through your appeals process as well. Filing an appeal and even appearing before an Administrative Law Judge can be intimidating. But with a knowledgeable and experienced attorney by your side, you can confidently explain what happened with your claim.
Take control of the waiting time that comes with the worker’s compensation process and demand a resolution. Hire an attorney and put your focus on closing your claim.
Call the law offices of Ashcraft and Gerel for hands-on help from a worker’s compensation attorney who’s interested in resolving your claim. They will do everything possible to find out why your claim is taking so long and to get it moving again.
