The answer to your question depends on where you live. State law determines the rules for workers’ compensation, and the deadlines for responding to claims by injured employees are different in each state. In most states, however, your employer’s insurance company should respond in about two to three weeks after you’ve given notice of the injury or filed a claim. In Texas, for instance, the insurer must either deny the claim or begin to pay benefits within 15 days after it received written notice. The deadline in Pennsylvania is 21 days after notice of the injury.
If you don’t receive an answer within the deadline, some states will consider your claim to be accepted. For example, California requires the insurance company to reject a workers’ comp claim within 90 days after the employer first learned about the injury; otherwise, it’s presumed that the claim is approved. However, the insurer can overcome that presumption and deny the claim if it discovers new evidence after the end of the 90-day period. For having more information at first go on workers compensation audit
Many states allow insurers extra time to investigate the claim if they pay benefits in the meantime. In Florida, for instance, the insurance company must either respond to a petition for benefits within 14 days after receiving a petition for benefits or pay benefits while it investigates. If it chooses the “pay-and-investigate” option, the petition will be considered accepted if the insurer doesn’t give a final answer within 120 days after it starts paying benefits, unless there’s new evidence.
See more about this topic: Workers Comp Audit
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