When you have a work related accident in Maine, you can claim workers’ compensation to pay for the costs of medical treatment for the injury. Workers’ comp can also pay for many out-of-pocket expenses like travel to medical appointments as well as some of the income you have lost as a result of an accident.
Your employer or their insurer will provide you with an accident report and a workers’ compensation claim form. In the state of Maine, your employer will need to fill out a Report of First Injury form and give you a copy. They must then pay your claim for lost time within 14 days or present a reason for denying the claim through a Notice of Controversy.
Some workers’ comp claims get honored with no problems, but a Notice of Controversy means that you will need to engage in a dispute with your employer and their insurer. In these instances, a workers’ compensation lawyer can often help you strengthen your case and argue more effectively as to why your claim should be honored.
Reporting Your Work Related Accident After It Happens
The first thing you want to do when you have an accident is tell your employer. The Maine Workers’ Compensation Board (WCB) requires that all workplace injuries are reported within 30 days. Waiting longer than that will likely invalidate your claim. Even waiting just a few days could also weaken your claim, even if you do not miss the 30 day deadline, as the physical evidence and recall of events are strongest right after an incident.
If you have a gradual injury, such as a strained back, you may not be able to pin down an exact “date of injury” since the condition became worse over time. In these instances, you must report your condition the moment you think it was caused by your job duties.
What You Should Include In Your Injury Accident Report
Your employer will need detailed information to complete their Report of First Injury. To help them, you should document your injury as well as the incident. Include the following information:
- A description of the injury, including the body parts affected, the pain you feel and how your mobility or ability to work is limited
- A detailed description of the accident event; if the injury was caused gradually, describe how you initially began to feel your symptoms and how you concluded that work duties caused the injury
- Any parties involved, such as coworker witnesses, supervisors who gave you your most recent instructions, and information given to you by third-parties, such as representatives from a machine repair company who examined the equipment that injured you
- A timeline of exact dates, times and locations for the accident, including events immediately before the accident and immediately after
- Any medical treatments or diagnoses you have received related to the injury
You will submit this report to your employer, but make sure to keep a copy for yourself. Your employer will also provide you with a copy of the Report of First Injury they will submit to the Maine WCB.
Receiving Treatment and Keeping Records
If your employer has assigned workers’ compensation cases to a selected healthcare provider, you must use that provider for the first ten days of treatment. After that, you can change healthcare providers as long as you notify your employer.
While undergoing healthcare, hospitals and clinics will bill your expenses to your workers’ compensation plan. Some out-of-pocket expenses may still result, such as any medical devices, any recommended over-the-counter medications and travel expenses to and from appointments.
Keep detailed documentation of all these costs. Save your receipts. Mark down your mileage for all related trips. Keep a copy of all pay stubs to demonstrate how your ability to work has diminished. Also, keep copies of any forms you have completed or documents given to you, especially medical reports.
Handling Disputes With a Workers’ Compensation Lawyer
Sometimes, your employer or their insurer will decline to cover a work related accident and instead send a Notice of Controversy to you and the Maine WCB. You can dispute the reasons behind this denial.
When you begin a dispute, a Troubleshooter will contact you to help resolve it. If the Troubleshooter is unable to bring about a resolution, you must then attend a mediation with your employer and any insurance representatives. You may request a formal hearing only if mediation fails to resolve the dispute.
Handling a Troubleshooter, mediation or formal hearing on your own can put you at a legal disadvantage. You may wish to have an attorney familiar with workers’ compensation laws to help you present your case convincingly, with concrete evidence backing it up.
You can contact Lowry & Associates at 207-775-3819 or fill out our free case review form to help settle your dispute and increase your chances of obtaining the workers’ compensation benefits you deserve.
