In an ideal world, all workers would be compensated for work-related injuries. Employees would file a workers comp claim, have it processed, and get compensation for their lost wages and medical expenses. But sometimes it’s not so easy.
Problems often arise during the workers comp claim process. The employee may be unwilling to pay, there may be issues with the DOL doctor, and so much more. Learn what issues you may face and how to deal with them.
What Common Problems Arise When Filing a Workers Comp Claim?
Your Employer Downplays Your Injuries
Employers know that their insurance will go up if you win your case. They may try to downplay your injuries so they are not on the hook for as many medical expenses. They may also try to say your injuries are not work-related, so they don’t have to pay at all.
If you work your case correctly, you will overcome false employer claims. Doctor’s reports, eyewitness testimonies, and medical records will speak for themselves. They will help you get the benefits you deserve.
Your Employer Does Not Follow Up
Filing a workers comp claim is a two-way street. You need to do your part by filling out the necessary paperwork and attending doctors’ appointments. Employers must also submit their information.
Your employer may be dragging their feet on filling out paperwork. It may be that they are too busy, or it may be that they don’t want their insurance to increase. If your employer is taking a long time filing your claim, bug them about it, and be persistent.
If they continue dragging their feet to the point where you think you are in danger of losing your benefits, contact a lawyer.
Fear of Retaliation
Many workers feel their employers may retaliate against them if they file a workers comp claim. They think their superiors may act out by cutting their hours, demoting them, or even firing them. Sadly, this is an all-too-real scenario.
Workers are protected from employers who retaliate against them—research to find out your rights. Make your employer aware that you are on to them. Hire a lawyer if necessary.
Your Doctor Downplays Your Injuries
Workers comp doctors are often on the insurance company’s side. They are registered with the insurance company. The company is responsible for giving the doctor work.
Like employers, insurance companies also want to make the lowest payout possible. Doctors understand this strategy. They may downplay your injuries, so the insurance company looks at them favorably and gives them more work.
In most instances, you will have the option of changing your doctor if you are unhappy with them. Laws vary from state to state concerning how often you can change doctors, and which doctors you can choose. Get familiar with local laws so you know your rights.
Your Claim is Denied
In a worst-case scenario, your workers comp claim may be denied. Most times, denial is due to a technical error. You may have filled out the paperwork incorrectly. In this situation, you can correct the paperwork and resubmit it.
It’s also possible that your paperwork was filled out correctly, and your workers comp claim was denied for other reasons. The insurance company may decide that your injuries are not work-related. Other factors could come into play.
If you feel your worker’s comp claim was unfairly denied, you have the right to appeal the decision.
The Patient Doesn’t Follow Through with Treatment
Your doctor visits weigh heavily in claim denial or approval, and the amount of compensation you receive. Sometimes doctors make incorrect diagnoses or treatment recommendations that interfere with your claim. But workers can also make impactful errors.
Patients must be truthful with their doctors when explaining how they were injured. They should not exaggerate. They should also not lie about their medical history.
They must follow treatment advice closely. They must attend every scheduled visit. Keep copies of your medical records if you need them down the line.
Workers must also see a doctor soon after they are injured. Different timelines apply based on whether the injury is an emergency, or whether it happened gradually over time. But either way, it’s critical to see a doctor ASAP.
If you hold off on seeing a doctor, you may not remember what happened when you were injured. It may also look like your injury wasn’t that bad. And if you wait too long, you may miss your window and lose your compensation.
Do I Need a Lawyer to File a Workers Comp Claim?
In most cases, you will not need a lawyer to file a workers comp claim. However, there are some scenarios where a lawyer will be necessary. They include:
- If your claim is denied: If your claim is denied because the paperwork wasn’t filled out correctly, your lawyer will ensure your future submission is correct. If the denial was based on other factors, a lawyer can represent you in court to increase your chances of receiving compensation.
- If your employer is dragging their feet: If your employer is refusing to do their part, and it’s getting to a point where you feel it will interfere with your claim, you may consult a lawyer.
- Your employer is retaliating: It is illegal for employers to retaliate against workers filing claims. If your employer treated you unfairly after you filed a claim, you can get a lawyer involved.
- You are having issues getting another doctor: A lawyer can help if you are not happy with your doctor and have trouble finding a new one.
A workers comp claim should not be difficult to file. However, some people face obstacles during the claims process. If you have a legitimate claim, the law is on your side. Good luck getting the compensation you deserve.