This page provides answers to the following questions:
- I had an accident at work. How do I file a workers compensation claim in my state?
- Should my employer have workers compensation insurance? How do I know I am covered?
- What are the conditions that enable me or prevent me from claiming benefits under my state's law?
- What benefits might I be eligible to receive?
- How much time do I have to file my claim? What are the stages of the claim process? What should I expect?
- If I'm not happy with the determination, how do I appeal?
1. I had an accident at work. How do I file a workers compensation claim in my state?
Any injuries that cause you to miss work for more than five (5) days or that could result in death or permanent disability or serious disfigurement should be reported to the state Workers' Compensation Commission. A report must be made within ten (10) days of the five day time lapse. Your employer should be notified of your injuries and/or your accident and the employer is expected to keep a report of the circumstances. You or your employer may file a Workers' Compensation-First Report of Injury of Illness form to file with the Commission. This form should be filed within ten (10) days of the employer receiving notice of the injury or accident. If your employer fails to file the requisite forms in a timely manner with the commission, your employer may be subject to penalty by the commission.
2. Should my employer have workers compensation insurance? How do I know if I am covered?
Any employer with five (5) or more employees should have workers' compensation insurance, although some exceptions may apply (i.e. employment covered by federal law, employment as an independent or subcontractor, farm work). Your employer may choose to purchase a coverage policy through an insurance provider or may become self-insured. The Mississippi Workers' Compensation Commission monitors self-insured employers and enforces compliance with the commission's rules and regulations as well as state law.
3. What are the conditions that enable me or prevent me from claiming benefits under my state's law?
The best way to ensure you will receive benefits and protect your rights during the claims process is to timely file all requested documents and to keep a detailed and accurate record of your medical expenses and records.
4. What benefits might I be eligible to receive?
Depending on the extent of your injuries and the details of your claim, you may be entitled to a variety of benefits.
Medical benefits are compensation for all reasonably related and necessary medical services and visits required in treating your injury. Your medical care-giver or physician will provide information as well as routine updates to your employer and/or employer's insurance provider regarding your treatment progress and injury prognosis.
Disability benefits are payments made to the injured employee over a period of time to compensate for lost wages as a result of your injury or disability from a work-related accident. These benefits will either be considered temporary disability benefits and/or permanent disability benefits. They are calculated as a percentage (roughly 66%) of the average weekly wages earned through your employment, pre-injury or pre-disability. These payments may be subject to certain minimum and maximum limitations depending on the circumstances of your claim.
Temporary benefits are paid during while an employee recovers from and injury or illness until you have reached maximum recovery or improvement. The disability only persists so long as you are incapable of receiving wages or continue to lose wages as a result of your condition. The benefits may be paid as temporary total disability benefits, if you are completely incapable of working and earning wages, or temporary partial disability benefits, when you are partially able to work.
You may receive benefits for disfigurement or permanent disability. A medical professional will evaluate the extent of your disfigurement or disability and assign it an impairment rating. The amount of benefits you may be entitled to will correspond to the impairment rating.
Death benefits may be available to your surviving dependents, like family or your estate, should your injury result in your death. This can include funeral expenses, a lump sum payment to a surviving spouse, or weekly benefits to surviving dependents.
The Mississippi Workers' Compensation Commission has also established the Rehabilitation Department to work with injured employees to provide vocational services. These are opportunities to help you return to the workforce, whether in your former field of employment or in a new one.
5. How much time do I have to file my claim? What are the stages of the claims process? What should I expect?
If you are not receiving what you believe to be the adequate amount of benefits from your employer/employer's insurance provider, you may request a hearing with the Worker's Compensation Commission. Upon request, the Commission holds a pre-hearing statement in which the issues, arguments, parties, witnesses, and evidence are laid out. This is also the time where written statements may be filed and depositions may be taken. After both parties have submitted their pre-hearing statements, a hearing is scheduled with the Commission to be heard by an Administrative Law Judges. The Administrative Law Judge will review the contents of the pre-hearing statements and make a determination regarding the issues of your claim.
If you or the opposing party are unhappy with the determination, you may request a review of the Administrative Law Judges decision before the Full Commission. You must request this review within twenty (20) days of the initial determination. The Full Commission may require you and the opposing party to submit a brief of law and fact or to provide an oral argument. The Full Commission will then render a decision affirming or reversing the decision of the Administrative Law Judge.
6. If I am not happy with the determination, how do I appeal?
A decision of the Full Commission is appealable to the state Supreme Court. A petition for appeal must be made to the Secretary of the Workers' Compensation Commission within thirty (30) days of the award/decision. All court rules and procedures will apply at this level.