Workers Compensation Claims: The Common Problems

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Employees with workers’ compensation claims problems need their questions answered. Workers’ compensation is designed to protect you if you become injured or ill due to a work-related incident. However in the case of filing a claim, there can be some conflicts and frustration. Workers’ compensation claims mentioned in the news tend to have a lot of information about how these claims hurt employers or how the employer needs to work harder in order to save money. But the big question is, what about the employees?

In times of employers trying to cut corners and do everything they can for the company, that doesn’t mean that the employee should be put at risk. If you become involved with a workers’ compensation claim, you should still get paid for any lost income and have your injury-related medical expenses covered.

Here are four common problems employees face once they file a workers’ compensation claim.

Timing for the Filing Process

In a typical case, you have 30 days to make a claim. If the claim is not made within that 30 day window, you may be told that your injury isn’t covered because you didn’t file the claim in time. It is always best to notify your employer as soon as possible. If you notify your employer verbally, make sure to always follow it up in writing.

Your employer should provide you with a form to fill out. If not, type up a report with the date, time, and any details regarding how you were injured. Paperwork will begin to be filed between you, your boss and the insurance company. You want to make sure you get copies of everything for your own files. This will be helpful later on if you need to call an attorney.

Doctors Visits and Treatment Confusion

In most cases, you are given the option of selecting from a list of physicians who are approved by the workers’ compensation company. Most employers won’t know this which is why it is important to seek out information about it early. Your personal doctor will most likely not be on that list. If you choose to go to your own doctor, the workers’ comp case won’t cover the cost.

When going to the doctor it is important to be aware of these things:

  • When discussing your injuries, don’t exaggerate them to be worse than they actually are. If you get caught, your entire claim could be denied.
  • Your treatment plan should be followed exactly. This includes going to all the appointments. If you do not follow the plan, the workers’ comp claim administrator might decide that you aren’t trying or that you are faking your injury.
  • Make sure to obtain copies of all your medical records for your visits. This will be helpful later on if you need an attorney.
  • There may be some dispute between the treatment that the doctor recommends and what the claim administrator will allow.

Retaliation After Filing Your Claim

This tends to occur when employers get upset. This is due to the increased costs they have to pay for workers’ comp insurance later. Retaliation can happen in a lot of different ways and tends to be a difficult thing to prove. It’s important to keep notes of the things that happen and when they occur.

  • Demoted at work
  • Denied a promotion
  • Receive lower pay or scheduled for less hours
  • Schedule is changed to be one you don’t like or one that is considerably worse than others
  • Supervisor or employer harasses you or puts you under extra pressure
  • Begin to receive discipline for no real reason
  • Get fired

Claims Denied

Out of all the problems from a workers’ compensation claim, the biggest problem is the claim being denied. This means that you’ll have to pay out of pocket for any rehabilitation or treatment needed or use your own health insurance to cover the costs. In addition, you might be out of work for a while and lose your income. Your employer may fire you, not because you filed the claim but because you’re not coming back to work.

Some of the reasons your claim may be denied include:

  • Filing your claim late
  • They say your work injury isn’t work-related or the company denies being at fault
  • The company claims you aren’t an employee but rather a contract worker
  • You’re accused of faking the injury

Workers’ compensation claims can be tricky which is why it is always important to seek out an attorney if you have questions. The claims can feel intimidating when the insurance company or your employer don’t want to meet their obligation. When your claim is denied or you feel that you’ve been treated poorly or lied to while trying to fight for your case, you need someone who will fight for you. Contact a workers’ compensation attorney at Ramos & Ramos today. Fill out our Free Case Evaluation to speak with an attorney about your specific case and any questions you may have.

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