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?
If you are injured while on the job, seek the appropriate medical care necessary. Report the accident details and information about your injury to your employer as soon as possible. Your employer must then report this information to the Vermont Department of Labor, Workers' Compensation Division within seventy-two (72) hours. Make sure to obtain a copy of this report for your own personal records. If your employer fails to file a report, you may call the Workers' Compensation Division and file a report on your own behalf.
2. Should my employer have workers compensation insurance? How do I know if I am covered?
With the exception of a few categories of employers, employers are expected to have insurance coverage for their employees under state law.
3. What are the conditions that enable me or prevent me from claiming benefits under my state's law?
Vermont state law contends that if you are injured on the job, you have a claim. Your receipt of benefits will depend on the extent of your injuries and the effects on your ability to work.
Your employer or your employer's insurance provider determines whether to accept liability for your injuries. If either party denies your claim, you may not be able to receive benefits. The employer or employer's insurance provider is required to provide a detailed account of why your claim was denied to you. Make sure to request information about these details in the event your claim is denied.
4. What benefits might I be eligible to receive?
Depending on the specific circumstances related to your injury, you may qualify for different kinds of benefits in varying amounts. Medical benefits will be provided for all reasonably necessary medical services and supplies related to treating your injury.
Wage replacement benefits will be paid to you if your injury prevents you from returning to work, either temporarily or permanently. Temporary disability, for example, is a type of wage replacement that will be paid to you if you are unable to return to work for a number of days. However, if you are able to return to work, but perhaps at a lesser capacity or part time, you may be entitled to temporary partial disability benefits that will compensate you for the difference in your pre-injury wages and post-injury wages. If your injury result in permanent impairment, loss of a body part or loss of function to a body part, you may also be qualified to receive certain benefits.
5. How much time do I have to file my claim? What are the stages of the claims process? What should I expect?
After notifying your employer about your work-related accident, your employer has seventy-two (72) hours to report the injury to the Workers' Compensation Division. The employer should contact the insurance provider about your injury. The insurance provider has twenty-one (21) days to make a determination about whether to accept liability for your claim.
If your employer or the employer's insurance provider deny your claim, you may contest the denial with the Workers' Compensation Division. The Workers' Compensation Division assigns a specialist to work with you, the employer, or the insurance claims adjuster to resolve any disputes associated with your claim. These specialists facilitate a number of roles, which can include providing you more general information, serving as a mediator among the parties involved, and also has the ability to issue interim orders with ongoing disputes.
If a compensation plan cannot be agreed upon, any of the parties involved may apply to the Workers' Compensation Division for a hearing. A commissioner will be assigned to hear the issues in dispute. The commissioner may determine that a mediation should be held to facilitate a resolution among the parties. If this is not recommended, the commissioner will issue an award and determination within sixty (60) days of the hearing being held. This is considered to be a final order and determination.
6. If I am not happy with the determination, how do I appeal?
Upon the issuance of an award by a commissioner, the parties may appeal the award within thirty (30) days of the date of the award to the superior court of the county the parties could file a civil action within. All court rules and procedures will apply to appeals at this level.