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What Is the Workers' Compensation 90-Day Rule?

Last updated: April 8, 2023

Workplace accidents happen every day, especially in labor-intensive industries. Most of the time, they result in strain injuries to the knees, shoulders, and back. For instances like this, injured employees may apply for worker's compensation. 

However, it's crucial to note that there is a 90-day rule for injury compensation claims. Understand the 90-day rule and its importance in worker's compensation claims by reading on.

What Is The 90-Day Rule?

What Is The 90-Day Rule in Worker's Compensation

The Workers' Compensation 90-Day Rule is a set of regulations that governs the time frame in which a worker can file a claim for workers' compensation benefits. This rule is important for employees and employers, as it provides a clear timeline for all parties involved in the process.

Under the Workers' Compensation 90-Day Rule, employees must file a claim within 90 days of the date of the incident, or the date of the injury, to be eligible for workers' compensation benefits. This rule applies to all work-related injuries, including physical, psychological, and occupational injuries. 

Under the 90-day rule, injured workers must consult specific physicians to get the medical treatment they need to recover. The employer must provide a list of panel physicians or a company doctor who may oversee the employee's treatment. 

If the employee chooses to consult a different healthcare provider, the worker's comp insurance carrier may be legally allowed to refuse the payment of the treatments. It is important to note that the 90-day period may vary depending on the state. 

Some states may have different rules and regulations regarding the filing period. It is important to check with the state's workers' compensation laws to ensure that the claim is filed within the appropriate time frame. 

What Happens After The First 90 Days?

As an injured worker, it can be difficult to know what to do if you have experienced an injury at work and the 90-day rule has passed.

The first step is to contact your employer’s workers’ compensation insurance company. This will allow the workers’ compensation carrier to begin reviewing your workers' compensation claim.

The second step is to hire a workers' compensation attorney. They can help you file a claim and ensure that you receive the benefits you are entitled to. They can also advise on handling any issues that may arise during the process.

The third step is to file a claim with the state's Workers' Compensation Bureau. The board will decide whether or not you are eligible for benefits and will also determine the benefits you are entitled to.

Finding Experts At Workers Compensation

Finding Experts At Workers Compensation

A worker’s compensation attorney can help you with various issues related to worker’s compensation, such as filing for benefits, negotiating with employers or insurance companies, and appealing denials or reductions in benefits. 

When looking for a worker’s compensation attorney, it is important to consider the following qualities:

  • Experience and Expertise: It is important to find an attorney who is well-versed in the laws and regulations regarding workers’ compensation claims.
  • Dedication and Commitment: The attorney should be willing to take the time to listen to your story and understand the details of your case.
  • Compassion and Understanding: A good attorney will take the time to understand the emotional and financial impact a workers’ compensation claim can have on your life and work to ensure that you receive the compensation you deserve.
  • Affordability: Ask your potential workers’ compensation attorney about their fees and any potential discounts they may offer.

Workers' compensation claims help injured workers get the medical help they need to recover and live comfortable lives. However, they come with filing deadlines, so you should work with a workers' compensation attorney to ensure you follow the workers' compensation 90-day rule.

Learn more about workers' comp by reading the Disability Help guide on qualifying for workers' compensation benefits.

Frequently Asked Questions 

For more information about the workers' compensation 90-day rule, here are the answers to people's most asked questions.

Do I have to visit the workers' compensation physician for my employer?

Yes, it is important that injured workers see their employer's designated physician for their medical care unless they have informed them in writing of their decision to go with their own physician.

How long can you receive workers' compensation?

The length of worker's compensation benefits depends on whether they are permanent or temporary, as well as the governing rules of the state where the claim was filed.

How long is the SC workers' comp period?

In South Carolina, injured workers may receive temporary workers' comp benefits for up to 500 weeks and lifetime benefits for permanent and total disability cases.

In California, how long can a workers' compensation claim be active?

On average, worker's compensation claims in California may be active for 104 weeks or two years. After this, the worker may apply for temporary or permanent disability benefits through the state if they are still injured.

How long can an injured worker in Pennsylvania receive benefits for temporary total disability?

If your injury is classified as a temporary total disability in Pennsylvania, you may collect workers' comp for lost wages for up to 90 days.

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Cheri Hermanson
Cheri leads our team of writers in producing the best quality content there is regarding society and disability, most especially those that helps ease the quality of life for our differently-abled loved ones.
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