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File a Claim

File a Claim

Injured workers (or dependents) that have not been properly compensated may wish to file a Claim for Compensation with the Division of Workers’ Compensation. However, injured workers have the responsibility to ensure that their injuries have been reported to their employers in a timely manner. Please review the Process for Injured Workers before filing a claim. If you wish to file a workers’ compensation claim, complete the Claim for Compensation and mail it to the Division (the address is included on the form). This form may also be obtained at any office of the Division of Workers' Compensation. The filing of a claim begins a contested case proceeding where an administrative law judge has the authority to decide the issues in dispute.

Workers’ compensation is intended to be a streamlined benefits system, but many workers’ compensation cases can be extremely complicated. For example, your workers’ compensation case can affect your entitlement to social security benefits, Medicare benefits, or unemployment compensation benefits. Before you make any decisions on your workers’ compensation case, you should read all the information available to you on this website, and/or consult with a lawyer.

If you decide to file a claim for compensation, it should be filed with the Division within the statutory period of limitation, which is:

  1. Within two years after the date of the injury or death or, last payment was made on account of the injury or death; or
  2. If the employer does not timely file a Report of Injury with the Division, within three years from the date of injury, or death, or last payment was made on account of the injury or death.

For additional information on filing a claim or other workers’ compensation questions, please call toll-free 800-775-2667.

Related: Claim for Compensation
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