How to file a workers’ compensation claim

Before submitting a workers’ compensation claim, it’s important to gather the right information. Accurate and complete documentation helps prevent delays and promotes a smoother process. You’ll typically need:

• Injured employee’s information: Full name, contact details, and job title

• Incident details: Date, time, and location of the injury or illness

• Description of the event: How the injury or illness occurred

• Medical documentation: Initial diagnosis, treatment notes, and healthcare provider details

• Witness statements or reports: If others observed the incident

• Employer records: Timecards, training logs, or safety documentation relevant to the case

Once you’ve gathered the necessary information, the next step is to file the claim with your workers’ compensation insurance carrier.

In most cases, employers submit claims directly through their insurance company’s claims portal or reporting system. However, the exact filing process can vary depending on your state’s workers’ compensation regulations and your policy type. Some states may require you to also submit documentation through a state workers’ compensation agency.

At Sentry, we make filing easy through our Claims Center. You can submit a claim online, review next steps, and access helpful resources to support both your employees and your business throughout the process.

After your claim is submitted, your insurance carrier will review the details to determine eligibility and benefits. Here’s what typically happens next:

• Claim acknowledgment: The insurer confirms they’ve received the claim and may reach out for additional information.

• Investigation and review: The carrier evaluates the incident, reviews documentation, and communicates with any medical professionals involved.

• Benefit determination: If the claim is approved, benefits—such as medical care and wage replacement—are arranged.

• Ongoing communication: You, the employee, and the insurer work together to monitor progress and plan for a potential return-to-work timeline.

If a claim is denied, employers or employees may have the option to appeal the decision, depending on state law. Staying informed and maintaining open communication throughout the process helps keep things on track.