After a covered employee is injured at work, it is important that the covered employee knows the time limitations associated with a workers’ compensation case. There are three types of claims that can be brought under workers compensation: (1) accidental injury, (2) occupational disease, and (3) death benefits.
Accidental Injury
A covered employee who is injured on the job has 10 days from the date of the injury to notify the employer of the injury. This notice can be given in writing, or otherwise. Thus, if an employee is injured in the presence of a supervisor, this is notice. Failure to provide the employer with notice of the accidental injury bars the employee from bringing a workers’ compensation claim unless the Commission excuses the failure to provide notice on the grounds that notice for some sufficient reason could not have been given or the employer-insurer was not prejudiced by the lack of notice. The employer-insurer must prove prejudice by show specific evidence that the failure to give timely notice actually harmed its ability to defend the action.
A claim for an accidental injury must be filed with the Commission within 60 days after the date of the accident, but failure to file a claim within this time frame may be excused by the Commission if the employer-insurer was not prejudiced by the failure to file in time. Absent substantial evidence of prejudice, it is presumed that the employer-insurer was not prejudiced by the failure to file within 60 days.
Although the employee should file the claim within 60 days, the employee must file the claim within 2 years of the accidental injury. There is no excuse for failing to file within 2 years of the accidental injury and this time deadline will not be waived by the Commission. Even if the employee was not aware of he/she sustained an accidental injury, the time period is not extended.
The time for filing a claim for accidental injury may be extended in very limited circumstances. First, if the employer fails to provide notice to the Commission of the accidental injury, as required by statute, the limitations for the employee to file a claim is extended. Thus, the statute of limitations does not begin to run until the employer’s report is filed with the Commission. Next, the time period for filing a claim for accidental injury may be extended in the case of fraud or estoppel. This is rarely granted, however, if the employer, by some unconscionable, inequitable, or fraudulent act, causes the employee to not file a claim in time, the limitations are extended by one year from the time when the facts and circumstances amounting to an estoppel cease to operate.
A covered employee who suffers from a compensable occupational disease must provide notice to the insurer within one year after the employee knows or has reason to know he or she is suffering from an occupational disease. Failure to provide notice bars a claim for compensation. See above.
A covered employee must file a claim with the Commission within two years from the date of disablement or the date when the employee first had actual knowledge that the disablement was caused by the employer. Unlike an accidental injury, the time for filing a workers’ compensation claim for an occupational disease is not extended by the employer’s failure to provide notice to the Commission of the disease. The fraud and estoppel exceptions to the filing deadline apply to occupational diseases. In addition, the defense of notice or limitations is waived if the employer makes compensation payments, or by affirmative conduct leads the employee to believe that notice has been waived, or where the employer fails to raise this defense at a hearing before the Commission prior to an award being made.
Notice that a covered employee died as a result of a work-related, accidental injury must be given to the employer within 30 days of the death. In the case of an occupational disease causing death, notice must be given to the employer within one year after the death resulting from the occupational disease.
A claim for death benefits resulting from the death related to an accidental injury must be filed with the Commission within 18 months from the date of death. A claim for death benefits resulting from the death related to an occupational disease must be filed within two years from the date of death, regardless of whether the employee’s dependents were aware that the death was caused by the employment.
(Rated: 5.00
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