The nature of the injury should be studied by the examiner. If the first report reveals the injury to be slight but the claimant is contending disability, the case should be assigned for investigation. The employer and the attending physician have to be interviewed. The examiner must also arrange for a medical examination by one of his own consultants. An effort must be made to determine the true extent of injury and the anticipated period of disability.
The case should be investigated thoroughly if the first report indicates the injuries to be severe with disability likely to be prolonged. A payroll record of the claimant for the year prior to the accident must be obtained from the employer so that the average weekly wage of the claimant can be figured and a proper rate of compensation established.
If the injury appears to be slight and the claimant is not losing any time from work but the attending physician indicates that treatment will continue indefinitely, a prompt medical examination by a consultant should be arranged to determine the necessity for continued treatment.
The lawyer has to file with the responsible state agency all required forms as stipulated in the law. Administrative requirements have to me met and fulfilled. For example, notice of payment must be filed; employer’s report of accident must be filed. If payment of compensation is indicated then benefits should be promptly instituted. Delays of payment to injured employees in non-controverted cases must be cut to an absolute minimum.
There are many different kinds of people involved in the processing of a claim. These include the employee, the employer, witnesses of the accident, the doctor, the claim staff of the insurance company, investigators, the state boards, referees, commissioners, clerks, typists, file boys, statisticians and mail clerks.
Compensability
The injury lawyer in determining the compensability of claims has basic checkpoints to be reviewed. The accident must cover within the scope and jurisdiction of the Personal Injury Law and Policy.
