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How Long Does A Workers Comp Claim Remain Open

How long your workers' compensation case stays open will depend on a variety of factors. Every case is different: different injury, different employee and employer, different insurance company, and different facts. A few of the factors affecting case closure include the benefits you need, your rehabilitation plan, the insurance company's denial of benefits, and progress of settlement discussions.


Depending on your injury and the time you miss from work due to the injury, you will be eligible for different types of benefits. If you miss no time from work, your claim will remain open while you receive any medical care you need. In Connecticut, If you miss time from work, payment of your wage loss benefits will begin after you have been disabled for 3 days. After that, you can receive wage loss benefits indefinitely  depending on your injury and whether you can return to work. In Connecticut your claim will remain open during this time.

The timing for receiving your workers' comp wage loss check depends on several factors. In Connecticut , an employee must be disabled for at least 3 consecutive days  before wage loss benefits are owed. Disability lasting 3 days  or more will result in payment going back to the first missed workday. According to the 2019 Pay Lag Report, it is common for payments to begin on the 14th day, although some insurance carriers may wait 30 or more days before initiating payment. To potentially speed up the process, you can request to have your wage loss benefits directly deposited. However, it's important to note that the average time for payment in Michigan is approximately 17 days, excluding cases where a Notice of Dispute has been filed. Late payment of workers' comp checks is often attributed to poor claims handling, unresponsive employers, or medical providers not sending required records. In such cases, there may be a $50 per day penalty if wage loss benefits are not paid within 30 days of becoming due, up to a maximum of $1,500. In order to ensure proper documentation, it is recommended to send any required paperwork via certified mail with a return receipt, providing proof of submission. In the event that your wage loss check is significantly delayed, it might be advisable to seek legal advice, as it could be an indication that your workers' comp benefits are being disputed. It is worth noting that if an insurance company insists on an independent medical examination (IME) before starting payment, this could potentially be perceived as an attempt to avoid paying fair assessments. However, it's important to consider that late or missing checks can sometimes result from oversights or errors.

What happens if My Workers Comp Check is Late?

If your workers' comp check is late, there are a few things you should know. In Connecticut , to receive a workers' comp wage loss check, you must be disabled for at least 3 straight days . This means that if you are disabled for 2 weeks or more, the payment will be retroactive to the first missed workday. The law in Connecticut  requires that payments begin on the 14th day. However, according to the 2019 Pay Lag Report, the average time for payments to start is 17 days. Some insurance carriers may even wait 30 days or more to begin payment. It's important to note that this timeframe does not include claims with a filed Form 43 Notice to Contest Right To Compensation. If your checks are considered late, which is typically when they are 30 days past due, there is a penalty for non-payment. However, this penalty has a maximum limit of $1,500. In order to have proof of submission, it is recommended to send any required documentation by certified mail with a return receipt requested. If your wage loss check is late, it might be a good idea to contact an attorney. This could indicate that there may be a dispute over your workers' comp benefits. Be cautious of claims adjusters who insist on an independent medical examination (IME) before starting payment, as these assessments may not be fair and could be a sign that the insurance company is trying to avoid paying. However, it's important to remember that sometimes late or missing checks can be a result of simple oversight or error.

Rehabilitation Plan and Return to Work

If you participate in a vocational rehabilitation plan such as one offered by the Connecticut BRS,  your workers' compensation claim will remain open while you finish the plan.  Workers Rehabilitation services are available to injured workers in Connecticut even if they close out their claim by a full and final settlement.

It takes some injured workers a long time to return to work, whether because of the extent of their injuries or because they need changes to their job to continue working. A knowledgeable workers' compensation lawyer never pushes his or her clients to return to work before they are ready, even if the claim stays open for years.

Denial of Benefits and Claim Petition Process

Workers' compensation cases take longer to close if the insurance company denies benefits and the worker is required to pursue the claim to a formal hearing, or trial in the Workers Compensation Commission.. At this point, the worker and the insurance company conduct discovery and depositions to find out important medical information and other facts that may resolve the dispute over compensability. This can take six months or more to complete.

If the parties do not resolve the dispute (see below), the claim will go to a formal hearing before a workers' compensation Commissioner.. The hearing is like a court trial and will last a half-day or more. After the hearing, the Commissioner will issue a decision resolving the dispute. The injured worker or the employer can appeal the judge's decision to the Workers' Compensation Review Board and further to the Connecticut Appellate and Supreme Courts if necessary.

Possible Settlement

Some workers' compensation cases settle long before they go to a hearing. Settlement involves a compromise between the worker and the insurance company. The company agrees to pay a certain amount of money in exchange for a release of the worker's claims. Regardless if the claim is closed by settlement, the option for rehabilitation benefits  continues..

Need help getting workers’ compensation for your injury? The Law Offices of James F Aspell, P.C.  stands up for injured Connecticut workers' rights. Jim's 30 plus years of workers' compensation experience and his team's dedicated service combine to get clients the results they need. To schedule a free consultation, contact us online or call us at 860-500-1414.


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