What to Avoid When Filing a Workers’ Compensation Claim

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What to Avoid When Filing a Workers’ Compensation Claim

Without the proper coverage, getting hurt on the job can be as devastating to your finances as it is to your personal health. Most people assume they will be covered by workers’ compensation in the event of a workplace accident or mishap, and usually they’re right. Employers do hold a certain level of responsibility and accountability for what happens under their watch in their workplaces, which is why seeing a person denied due to mistakes or improper filing of a workers’ compensation claim can be one of the most disheartening aspects of our job as attorneys.

Workers’ compensation laws are meant to provide no-fault insurance coverage for employees, but as is the case with most governmental programs, it’s not readily obtained without a healthy dose of red tape and bureaucracy. In almost every case, it might be best to call The Law Offices of Dianne L. Sawaya LLC for assistance navigating these murky waters. In the meantime, here are some tips and advice for avoiding the potential pitfalls when filing a workers’ compensation claim.

1. Failure to Immediately Notify Employer

The law says you should notify your employer within 4 days of the injury you’ve been hurt. Waiting too long to tell your employer about a workplace injury might be the most common mistake people make when filing a workers’ compensation claim.

There are various reasons as to why a person might wait to inform his or her employer of an injury. For example, maybe that person wants to avoid being seen as “soft” or as a complainer (especially in a blue collar type profession), or perhaps he or she underestimated the severity of the injury at the time it occurred.

The time frame for injured workers varies from state to state. Still, it’s best to notify an employer as soon as possible. This reduces the likelihood that they might believe your injury actually occurred outside of work and ultimately deny your claim. There’s no harm in reporting an incident that doesn’t end up being a serious injury, but you stand to lose numerous hours of work and money in the event of the opposite.

Finally, make sure to be as specific and detailed as possible when you do report your possible injury. The more documentation you can show, the easier it will be to prove your claim later on.

2. Failure to Properly Explain the Injury to Doctor

Almost as important as reporting the incident to your employer in a timely manner is ensuring that you properly explain the injury and resulting conditions to your examining physician/doctor. The benefits you ultimately do or do not receive will be based largely on the accident report and medical records. Failing to do so thoroughly can hurt you, especially in the event of a disputed claim.

For some people, it’s only natural to downplay injuries and ailments, but this is not the time to be a hero or “tough guy.” While you certainly don’t want to embellish your potential injury (see: fraud), you also don’t want to do the opposite. The specific language and words you use can be used for or against you when insurance adjusters are making their determinations. For example, we discourage you from saying something like the following: “It didn’t hurt that bad I guess. I was able to keep working and finish my day, so I don’t think it can be a serious injury.” Instead, we recommend you say something like this: “It was painful, but I was able to manage the pain and finish my work day before deciding to report it and find out if I really injured myself.” Be honest and open, but let the medical professional make the determinations on injury severity. Otherwise, your own words might get turned against you in the event of a dispute.

3. Failure to Follow Rehabilitation/Treatment Plan

Laws vary by state when it comes to the doctor who may be seen for treatment, and, oftentimes, the employer gets to pick. However, one universal requirement is that, in the event the doctor creates a treatment/rehab plan for the injured worker, it must be followed. If the person refuses or it can be proven that he or she is not following through, workers’ compensation payments may be suspended or forfeited altogether.

4. No Attorney Present & Believing Insurance Adjuster is Looking Out for You

This may sound cynical, self-serving, and biased, but the dangers are very real. Insurance adjusters are paid to figure out if—and to the extent of which—you are injured. Saving the insurance company money is in their best interest. There are technically three parts to every workers’ compensation claim that involve monetary payments: permanent physical impairment, future medical benefits, and vocational benefits. It’s best to have an attorney with you before agreeing to any settlement. This will help to ensure that you get the proper restitution you deserve.

Another aspect of this is the potential disability rating a doctor may assign you. In the event you cannot fully recover from your workplace injury, a doctor may assign you a permanent partial disability rating. This rating will ultimately play a huge role in how much compensation you’re awarded. Naturally, it’s common for employer-appointed doctors to favor lower standards. Attorneys at The Law Offices of Dianne L. Sawaya LLC can help make sure you get your just due.

5. Returning to Work Too Soon

On a practical level, returning to work too soon can have serious implications on your long-term health. It’s important to make sure you’re physically prepared to handle the responsibilities your job entails and return when you and your doctor feel you’re ready. Do not be pressured by your employer or anyone else for that matter.

Workers’ compensation is a crucial part of our society, but there is a great deal of complexities involved in it. If you or someone you love is in the process of navigating these tricky waters, call the Colorado workers’ compensation attorney at The Law Offices of Dianne L. Sawaya LLC today, and find out how we can help.

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