Time Limits on Filing Workers Compensation Claims for Employees and Employers

We often hear the question: How long do we have to file a workers compensation claim? The answer depends on whether you are an employer or an employee. While the time requirements vary from state to state, the time restraints for the employer to file a workers’ compensation report are almost always more restrictive than the time limits are for the employee.

While the employer is technically responsible for reporting the work comp claim to the state workers’ compensation board, work comp insurers often perform this function for the employers. A few states insist the employer report the claim, but most states just the want the claim reported timely and do not care who sends in the claim.

The claim is normally reported on a form called the Employers First Report of Injury, also known as the E1 in some states. When the employer reports the claim to the insurance company, the insurer has the experienced adjusters who know the state requirements for the information required on the Employers First Report of Injury. In the states that require supplement updates, the claims office always will file the additional reports with the state work comp board.

California requires serious injury and death claims to be reported immediately to the Division of Workers’ Compensation. Colorado also requires death claims to be reported immediately. Michigan requires death claims, disabilities of 7 days or more and some specific losses to be reported immediately. [No explanation as to how the employers will know immediately the employee will be off work 7 days in the future on minor indemnity claims]. Washington state also requires immediate reporting of death claims and claims involving hospitalization.

Most states give an overall time limit on when the employer must have the Employer First Report of Injury filed with the state. Generally, the time limits vary from 2 days to 15 days. However, a few states give the employer more leeway in reporting the claims. In Georgia, the employer has 21 days to report the claim to the state, while Kansas gives the employer 28 days to report the claim. Missouri gives the employer the most time to report the claim, 30 days.

While a few states (Alabama, Arizona, Colorado, Michigan, North Dakota and West Virginia) do not impose any penalty on the employer for failing to report the claim, most states have the option of imposing a fine on the employer for late reporting. Texas requires indemnity claims to be reported within 8 days. If not, the Texas Division of Workers’ Compensation can fine the employer up to $25,000 per day, per offense. [That would only happen to the employer who intentionally and repeatedly failed to report work related injuries].

The maximum fine that can be imposed on the employer for late reporting varies by states. Arkansas has a really strict penalty for not reporting the claim within its 10-day time limit – a $10,000 fine and it is classified as a Class D Felony which can involve imprisonment for the employer! Hawaii, Virginia and Vermont have a maximum fine of $5,000, but no imprisonment. New York and New Hampshire have a maximum fine of $2,500 for late reporting. All the other states have fines of $100 to $1,000.

While the employee has more latitude in when to file a work comp claim, the employee also has more to gain by filing the claim timely. The employee cannot collect indemnity benefits until the claim is reported.

A few states including Arizona, Arkansas, Connecticut, Hawaii, Washington and West Virginia require the employee to give notice of the claim to the employer “forthwith” or immediately, without delay. However, each of these states give the employee a free pass on the requirement to notify the employer if they have an excusable reason.

Most states have time frames for notifying the employer that vary from 2 days to 30 days, with longer “excusable” times being permitted. Excusable events vary by state, but in reality few insurers ever try to deny a claim because it was not reported timely. Some states require the claim to be in writing to the employer, while other states do not specify the means of reporting the claim to the employer.

Delaware gives the employee up to 90 days to report the claim, after which no compensation is due until the employee does notify the employer. [This doesn’t make much sense, as the employer will notice well before the 90^th day the employee is not at work. If the employee is at work, then indemnity benefits would not be owed].

Iowa gives the employee 90 days to report the claim to the employer, unless the employer already knows about the injury. Louisiana gives the employee 30 days to notify the employer, unless the employer has not posted the work comp reporting requirements per state law, then the employee has one year to report the claim to the employer. Utah gives the employee a straight 180 days without qualifications.

If you are an employer – it is absolutely to your advantage to report the claim as soon as possible to the insurer, or the state if the state will not accept the E1 from the insurer. The sooner you report the claim, the quicker the adjuster will be able to start the claim investigation, and the sooner necessary services and benefits can start to flow. If you are the employee – the sooner you report the claim to the employer, the sooner your benefits will start.