Workers Compensation Intake: The 5 Questions That Qualify a Case

Most law firms treat workers compensation intake like personal injury intake with a different header on the form. That is a mistake that costs firms cases every week.

Workers comp is a separate track. The statutes are different. The deadlines are different. The qualifying criteria are different. And the questions that tell you — in the first three minutes of a call — whether you have a viable case are completely different from anything on a standard PI script.

This guide gives you the five questions that should drive every workers comp intake call, explains what each answer tells you, and shows you the red flags to watch for before you invest another minute in the conversation.

Why Workers Comp Intake Requires Its Own Protocol

Personal injury intake is about liability and damages. Workers comp intake is about something different: eligibility and process position.

In PI, you are asking who was at fault and how badly was the person hurt. In workers comp, fault is largely irrelevant. The questions that matter are whether the injury happened in the course and scope of employment, whether proper procedures were followed, and where the claim sits in the administrative process right now.

That shift in framing changes everything about how the first call should go.

Whoever picks up the phone at your firm — receptionist, paralegal, whichever attorney happens to be walking by — needs a workers comp-specific script. A generic intake form will miss critical qualifying information, waste time on irrelevant questions, and fail to flag the red flags that would have killed the case in the first fifteen minutes of attorney review anyway.

The five questions below give you what you need to know before you commit the next hour to an intake and case evaluation.

The 5 Questions That Qualify a Workers Comp Case

Question 1: When Did the Injury Happen and Did You Notify Your Employer?

This is your statute of limitations and procedural compliance question, and it comes first for a reason.

Every state has a workers comp statute of limitations — typically one to three years from the date of injury, though some states use the date of diagnosis for occupational disease claims. Ask for the exact date. “About six months ago” is not enough. You need a date.

Then ask about employer notification. Most states require an injured worker to give written notice to their employer within a specific window — often 30 to 90 days — or they forfeit the right to compensation. If your caller did not notify their employer promptly, find out why. Some states allow exceptions for good cause; others do not.

What the answer tells you: Whether you are still inside the statute and whether there is a procedural bar to recovery before you even get to the facts of the injury.

Red flag: Injury happened more than 18 months ago with no prior attorney and no open claim. Your statute clock may have run. Do not assume — verify your state’s exact timeframes — but flag it immediately.

What to ask: “What is the date the injury happened, or the date the doctor first connected your symptoms to your work? And did you tell your employer about it in writing, and when?”

Question 2: Did You Seek Medical Treatment, and Did the Workers Comp System Pay for It?

Medical treatment establishes the nexus between the injury and the work. Without medical records linking the injury to the job, you have a story, not a case.

Ask whether the caller received any medical treatment. Ask who paid for it — the employer’s workers comp carrier, their own health insurance, or out of pocket. Ask whether the employer directed them to a specific doctor or clinic, which is standard in many workers comp systems and matters for your treatment narrative.

If the workers comp carrier has been paying for medical treatment, that is strong evidence the claim was accepted. If the caller paid out of pocket because the employer told them not to file a claim, that is a different situation entirely — and potentially a retaliation or suppression issue worth investigating.

What the answer tells you: Whether there is a medical record trail and whether the claim has been formally accepted or is in dispute.

Red flag: No medical treatment at all. A workers comp case without medical documentation is extraordinarily difficult to prove. The injury may be real, but without records, you are building on air.

What to ask: “Have you seen any doctors for this injury? Who paid for those appointments — your employer’s insurance, your own insurance, or yourself? Did your employer tell you where to go for treatment?”

Question 3: Has the Claim Been Accepted, Denied, or Is It Still Pending?

This question tells you where you are in the administrative process and what kind of legal work is actually needed.

Workers comp cases arrive in three states. Accepted claims mean a carrier has taken responsibility — your client may need help with ongoing treatment disputes, permanent disability ratings, or settlement negotiations. Denied claims mean the carrier rejected the injury or the eligibility, and you are looking at an appeal or hearing. Pending claims mean no decision has been made yet, and the caller may need help navigating the initial filing.

Each scenario requires a different approach and involves different potential fee structures, timelines, and litigation complexity. Knowing where the claim stands before the attorney reviews the file means no one spends 45 minutes on an intake call only to discover it is a simple accepted claim where the caller just wants to understand their rights.

What the answer tells you: What kind of case this is and what resources it will require.

Red flag: The carrier denied the claim more than a year ago and the caller did not appeal. Every state has a deadline for appealing a denial. If that window has passed without action, recovery may be severely limited or barred. Flag this for attorney review before going further.

What to ask: “Has the workers comp insurance company told you whether they are accepting or denying your claim? Or are you still waiting to hear from them?”

Question 4: Were You Unable to Work Because of This Injury, and for How Long?

Lost wages are often the biggest component of workers comp value. Workers comp pays temporary disability benefits — usually two-thirds of pre-injury wages — for time missed from work. Permanent disability benefits, if the injury results in lasting impairment, can be worth significantly more.

Ask how much work the caller missed. Ask whether they are still off work or whether they have returned, and if they returned, whether they came back at full duty or light duty. Ask whether they received any disability payments during the time they were off, and if so, whether those payments were the correct amount.

A caller who was off for two weeks and is back at full duty is a very different case than someone who has been out for eight months with a spinal injury and is being pressured to return before they are medically cleared.

What the answer tells you: The wage-replacement component of the case value and whether there are any underpayment or premature return-to-work issues to investigate.

Red flag: Caller returned to work at full duty and is not experiencing ongoing limitations. If there are no permanent restrictions and the medical treatment is complete, the case value may be limited to past wage loss and medical bills, which may not justify the cost of representation. Not a disqualifier, but worth calibrating expectations before the attorney review.

What to ask: “How much work have you missed because of this injury? Are you back at work now? If so, are you at full duty or on restrictions? Did you receive any disability payments for the time you were out, and were they the right amount?”

Question 5: Do You Have Any Prior Injuries or Pre-Existing Conditions to the Same Body Part?

This question makes some callers uncomfortable. Ask it anyway. Knowing about prior conditions before the attorney review is far better than discovering them later through medical records or a deposition.

Workers comp carriers aggressively use pre-existing conditions to apportion or deny claims. If your client hurt their back in a prior car accident, had prior treatment for a shoulder condition, or has a degenerative disease that the carrier will point to, you need to know now. Not because pre-existing conditions automatically bar recovery — they do not in most states — but because the case strategy changes significantly when a prior condition is in the picture.

Under the aggravation doctrine, which most states recognize, a work injury that aggravates, accelerates, or combines with a pre-existing condition is still compensable. But you will fight harder for it, and the case preparation looks different.

What the answer tells you: Whether there is a prior condition defense the carrier will raise and whether the case requires an aggravation theory.

Red flag: Caller had the same injury, to the same body part, treated by the same doctors, two years ago — and did not disclose it initially. This is a credibility issue that will follow the case through every hearing. You need to know before you commit.

What to ask: “Before this injury at work, had you ever had any problems, injuries, or treatment for the same area of your body — even from years ago? Even from a different job or a car accident?”

After the 5 Questions: What to Do With What You Have

By the time whoever is covering your phones has gotten through these five questions, they should have a clear picture of four things:

1. Procedural standing — whether the claim is timely and whether proper notifications were given
2. Medical foundation — whether treatment records exist to document the injury
3. Process position — whether the claim is accepted, denied, or pending
4. Case value indicators — how much time was missed and whether permanent impairment is in play
5. Defense exposure — whether a prior condition will be used against the client

This information does not belong in a person’s head. It belongs in a written intake summary that goes to the reviewing attorney with the call recording attached. The attorney can then evaluate the file in ten minutes instead of conducting their own full intake from scratch.

That ten-minute review is where the real qualifying decision gets made. The five-question front-desk script is not designed to make that decision — it is designed to give the attorney everything they need to make it fast.

The Intake Calls That Should End Early

Some workers comp calls should not go to attorney review at all. Whoever is handling intake needs to know when to end the call professionally and refer elsewhere.

Statute of limitations expired with no tolling argument: If the injury was three years ago with no attorney and no prior claim, and your state has a two-year statute with no applicable exceptions, the intake should end with a brief explanation and a referral to the state workers comp board for any options that may remain.

Claim fully resolved with signed settlement: If the caller signed a settlement agreement and received compensation, the case is closed. They may not understand that, and explaining it is a service — but there is no representation to offer.

Independent contractor, not employee: Workers comp does not cover true independent contractors in most states. If the caller was a 1099 worker with full control over their schedule, tools, and work methods, this is a classification question that typically falls outside the workers comp system — though misclassification claims are worth flagging to the attorney if the caller was economically dependent on a single company.

Being clear about these situations early is not bad service. It is honest, efficient, and far better than stringing someone along through a full intake when there is nothing to be done.

How AI Intake Coaching Applies to Workers Comp Calls

Workers comp calls are technically demanding. The caller is often stressed, unfamiliar with the administrative process, and may have been given bad information by their employer or the employer’s insurance adjuster. Whoever handles the call has to gather specific factual information while keeping the caller calm enough to actually provide it.

That is a skill that develops over time — but only if someone is watching, scoring, and coaching the calls where it goes wrong.

AI intake coaching tools listen to calls in real time and flag when key qualifying questions are missed or when a caller shows signs of disconnecting. In workers comp, where missing the prior condition question or skipping the employer notification timeline can mean the case intake is worthless, those real-time prompts matter.

They also create the call recordings and transcripts that let attorneys review intake quality without sitting in on every call. A firm running ten workers comp intakes a day cannot have an attorney listen to all ten in real time. But an attorney can review flagged calls — the ones where a qualifying question was skipped, the ones where the caller mentioned a denial date that might have passed, the ones where something did not add up — in a fraction of the time.

That review loop is what separates firms that catch case-killing problems in intake from firms that discover them at deposition.

Building the Script Into Your Intake Process

The five questions in this guide are not a magic solution. They are a floor — the minimum information your intake process needs to gather on every workers comp call before it goes to attorney review.

Build them into your intake form. Train whoever answers your phones to ask them in sequence. Make sure the call recording system is capturing the answers. And review the calls where cases got through intake that should not have, so you know where your process is leaking.

Workers comp intake is not glamorous. It is procedural, detail-oriented, and unforgiving when it goes wrong. But it is also one of the highest-leverage things a law firm can systematize, because the firms that do it well sign better cases faster and waste less time on cases that were never going to work out.

Five questions. Ask them on every call. Know what the answers mean. That is the whole system.

What to Do Next

1. Add these five questions to your intake form today — in order, as written. Print a one-page cheat sheet for whoever answers your phones.
2. Pull three recent workers comp intakes and check them — did whoever handled the call get answers to all five? What was missed?
3. Set a red-flag protocol — define the two or three scenarios (expired statute, fully settled claim, contractor status) where your front desk can close the call early without attorney review.
4. Start recording workers comp intake calls — not for surveillance, but so attorneys can spot-check the five-question compliance once a week.
5. Review the data quarterly — track which qualifying questions are getting skipped most often and retrain around those gaps.