Workers’ Compensation Investigations and What They Look For
Many workers risk injuries on the job, but there are mistakes that they should avoid in the event of an accident and subsequent injuries. These mistakes could prevent workers from recovering the total amount of compensation they actually deserve. The following is a list of mistakes that harm a work injury claim and how to avoid them.
Before a worker can file for workers' compensation benefits, he or she must notify his or her employer of the injury. However, workers only have a limited amount of time in which to report their injuries to employers, typically a specific number of days. In some states, workers need to report their injury as soon as possible, without a specific deadline.
Regardless, workers should report their injury immediately to avoid missing a workers' compensation claim time limit that might be in place. On the other hand, some exceptions may allow for a deadline extension, such as workers who don't become aware of an injury until long after the initial incident.
Employers and their insurers may require workers to visit pre-approved, in-network healthcare providers. Unless the employee is in a state where any doctor is permitted to examine the worker and diagnose a work injury, he or she will need to visit a pre-approved workers' compensation doctor.
Even if a worker is allowed to see any doctor, he or she should still ensure the doctor is sufficiently qualified. If there is any doubt as to the integrity of the doctor's diagnosis or prescribed treatment, it's best for victims to consult with a workers' compensation attorney to seek a second opinion from the attorney's recommended medical professional.
Workers frequently want to return to work as soon as possible to avoid potential financial hardships following a work injury. Even if workers receive benefits through a workers' comp claim, these benefits may not cover all utilities, medical expenses, or other costs. Despite this, employers are better off waiting to make a full recovery before resuming work, as returning early is one of many mistakes that harm a work injury claim.
In some cases, doctors may recommend that patients wait to fully recover before going back to work. Meanwhile, others may suggest that a patient can engage in light-duty work or that they've recovered as much as possible from their injuries. In these instances, it's still within a worker's best interest to speak with a lawyer with experience in workers' compensation claims to help determine whether he or she can truly return to work.
Workers must ensure their accident injury report contains accurate details pertaining to both the accident and their injuries. Intentionally or inadvertently submitting false details to employers could end with insurers denying a workers' compensation claim.
To avoid submitting a false report, workers should never try to embellish the details surrounding an accident, assume any information they don't truly know, or exaggerate the nature of their injuries.
After seeking treatment and diagnosis for a work-related injury, the injured worker will need to follow his or her doctor's orders if he or she believes they're sound and reasonable. Otherwise, failure to follow this advice could lead insurers to deny the workers' comp claim.
It's worth noting that pre-approved doctors in the insurer's network may provide the minimal amount of treatment required to help ensure the employee can return to work, which may eliminate the need for workers' compensation insurance companies to pay the full benefits for which injured workers actually qualify. This is why seeking a second opinion from an independent medical professional may be ideal if a patient doubt's the validity of the first doctor's advice.
Some workers may simply not understand the kinds of benefits they are eligible to recover, leading to lower amounts of compensation than they truly deserve.
Worker's compensation benefits include both medical and disability benefits. While medical benefits cover expenses related to treatment for the work injury, disability benefits can partially cover lost wages due to time taken off from work to recover.
Disability benefits will differ depending on the state. Employees often have access to permanent total, permanent partial, or temporary total disability benefits. However, they will vary from state to state. Injured workers in other states may also be able to recover other benefits, such as rehabilitation and retraining.
Workers who are inexperienced in workers' compensation may want to navigate the claims process on their own, but this could negatively impact their case. Working with an attorney can help effectively handle the entire process and further avoid mistakes along the way.
Any of these mistakes that harm a work injury case could result in significantly reduced benefits or denied claims. Avoiding them can increase a worker's chances of getting the compensation they need.