What to Do When Your Employer Refuses to File a Workers Comp Claim

Workers compensation rules can get complicated but are really simple – You get hurt, you get treatment, you get paid.

So what happens if your boss doesn’t follow the rules?

Specifically, what if your employer refuses to file a workers compensation claim?

Employers are required to post rules around the workplace that spell out what happens in case of an injury. If you’re involved in an accident, you might want to rip that poster off the bulletin board and slam it down on your boss’s desk and say, “Look at this!”

Such dramatics might be effective and make you a hero to your coworkers. But before you march into your boss’s office, you should arm yourself with as much information as possible. Here’s what you need to know.

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What to Do If an Employer Does Not Report an Injury

First, do not give your employer an excuse or legal justification for refusing to file a workers comp claim.

That means you must inform them of the injury. If you fall off a ladder, break your back and a screaming ambulance has to transport you to the hospital, it should be safe to assume your employer would be aware of the incident.

Don’t assume anything.

Your employer is supposed to provide you with a DWC-1 form to document the accident. It’s a pretty straightforward form that seeks the obvious information:

  • Date and time of the injury
  • Where it occurred
  • How it happened
  • What are your symptoms?

Even minor injuries should be reported.

It might seem silly to report a paper cut or bumping your head on a light fixture, but if that cut becomes infected or you develop headaches and you need medical treatment, you’ll want the original incident documented.

Deadlines for workers comp vary widely from state to state. South Dakota allows only three business days to notify your employer, while New Hampshire allows two years.

Once notified, your employer must file what’s commonly referred to as a “First Report of Injury.” If the employer doesn’t, he/she is breaking the law.

Stay on top of the situation. If your employer does not report your injury within a specified time, you should file a separate claim with your state’s workers compensation board.

If your employer does not provide you with a claim form, you can download one from the state board’s website. You also could have an attorney handle the paperwork and hound your employer.

Given the complexity of workers compensation laws, hiring an attorney is often a wise move, especially is your employer is dragging his/her feet.

How Long Does an Employer Have to Report an Accident?

As with an employee notifying the employer of an accident, the employer should act as soon as possible in notifying the state’s workers comp board.

Even though employers are required to fill out and submit a DWC-1 form, that doesn’t mean they will. That’s why there are deadlines.

They vary from state to state but are typically about 30 days. Florida, Texas and a few other states allow only a week.

Penalties for failing to comply also vary. The minimum charge is typically $100, but missed or late reporting can result in a $2,500 fine in California. In some states, it’s up to $7,000 depending on the severity of the injury.

And in case you’re wondering, such penalties are not typically deductible as a business expense.

Why Might an Employer Refuse to File a Workers Comp Claim?

Your employer is in business to make money, and workers compensation claims can take a bite out of a company’s profit margin.

Responsible employers know that’s just the cost of doing business. If they provide a safe working environment, the no-fault workers comp system will protect them from frivolously expensive claims.

There are legitimate reasons an employer would refuse to file a workers comp claim. At least they’re legitimate in the employer’s eyes.

For instance, your employer might believe he has a valid defense against your claim. Among the potential points of contention:

  • Your injury did not require medical attention.
  • Your injury did not require time off from work.
  • You were not actually hurt while on the job.
  • You filed a false claim.
  • You did not notify your employer within the required time frame.

All those are legitimate reasons you could be denied workers comp. They also are all potentially contestable, which is why you should consult a lawyer if your employer starts to play hardball.

What If Employer Has No Workers Comp Insurance?

Then there are illegitimate reasons, the first being your employer does not have workers compensation insurance of any kind. That would be a felony and punishable by six-figure fines and even jail time.

Another reason your employer might not file a claim is the nature of insurance. Workers comp is like auto insurance. The more you use it, the higher your next premium will be.

That’s why your employer might want you to use your private health insurance if you’re injured. Don’t do it. Be sure to tell the doctor you were hurt on the job.

Your employer might also offer to pay you while you’re not working. Again, don’t take that offer.
There is no guarantee such payments would continue. If your condition persisted or got worse, you would have missed the filing deadlines for workers compensation.

The bottom line is if your employer has a problem with your claim, he has the right to contest it. The system is set up to resolve such disputes.

What employers don’t have the right to do is not report a claim in the first place. If they do, act on the simple rule that’s the foundation of the workers compensation.

You get hurt, you get treatment, you get paid.

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About the author

Bill Fay has touched a lot of bases in his 45-year career. He started as a sports writer, gaining national attention for work on college and professional sports. He had regular roles as an analyst on radio and television and later became a speech writer for a government agency. His most recent work is as an internet content marketing specialist. Bill can be reached at [email protected].