Workers' Compensation Coverage
What To Do When An Accident Happens
Employer's Rights During a Claim
- An employer has the right to request that the insurance carrier contest the compensability of a claim. A claim can be contested for a variety of reasons, including, for example, that the injury was not related to work or that the employee is not injured to the extent he or she is claiming. An employer can request that the insurance carrier contest the claim, but since the carrier has assumed liability for the claim, it is not required to comply with the employer's request. In addition, employers or carriers who engage in dilatory tactics will be penalized.
- An employer has the right to attend any hearings related to a claim filed by one of the employer's workers.
- An employer has the right to electronically access the Board's case file for a claim filed by the employer's worker by visiting one of the Board's customer service centers. The Board's Electronic Case Folder (ECF) allows parties of interest to view the documents in the claim file electronically. Employers should go to one of the 11 district offices or 30 Customer Service Centers with identification to obtain a password. Based on the confidentiality of workers' compensation records, please be prepared to offer proof that you are the employer of record in the claim.
- A self-insured employer, or an employer who has failed his or her obligation to secure workers' compensation coverage, has the right to participate in the hearing and present relevant evidence about disputed issues at a hearing. Employers may request that a hearing be scheduled on a particular issue by writing to the appropriate district office in a timely manner. Corporations must be represented by counsel in proceedings before the Board. Certain defenses will be waived if they are not timely raised or if the employer or carrier does not timely file a Form C-7, Notice that Right to Compensation is Controverted.
- An employer has the right to report suspected workers' compensation fraud to the Fraud Inspector General. Fraud Referral Hotline: 1-888-363-6001.
- An employer has the right to seek administrative review or, if insured, to request that the insurance carrier seek administrative review on appropriate grounds a decision of a Judge regarding a claim filed by an employee.
Any party may seek administrative review of a notice of decision within 30 days by writing to the Board requesting Board review; however, a party filing a frivolous application will be penalized.