When Claim Problems Dog Your Workers' Compensation Case

Posted on: 6 December 2019

When workers' compensation insurance works properly, it provides hurt workers with a valuable asset. If hurt on the job, you can expect to have your medical needs totally covered. If you are ordered to stay home and recuperate, you are entitled to a partial disability wage while you doing so. Unfortunately, workers' compensation insurance companies can be difficult to work with and problems can occur. To find out about those problems and what to do when you encounter them, read on.

Understanding How Workers' Compensation Works

Your employer pays the premiums for your workers' compensation coverage, but they have little-to-no control over the actions of the insurer. If the workers' compensation insurer denies your claim, you are on your own. Like all insurers, workers' compensation carriers make money from the premium and lose money when workers have to be paid for injuries. Not only are they on the hook for the medical expenses and disability wages of hurt workers, but they often have to pay out large lump-sum settlements when workers have permanent injuries. That can mean insurers avoid paying out claims from hurt workers when possible. To that end, they can employ several tactics.

Claim Payment Avoidance Techniques

  • Making it difficult for employers to file claims for hurt workers with complicated claim forms and procedures.
  • Denying claims when no corroboration for the accident is found.
  • Alleging the hurt worker was under the influence of drugs when the accident happened, even if the employee had a prescription.
  • Ordering hurt workers to return to work even when an injury is not healed.
  • Offering hurt workers inadequate settlements for permanent injuries.

The above issues are just a sampling of what can happen to those who need the benefits provided by the workers' compensation insurer. If any of the above happens to you or if you are having issues with any aspect of your claim, take action.

Speak to a Workers' Compensation Attorney

Some hurt workers denied insurance benefits are reluctant to take action and seek legal help with their claim. They might worry about the cost or what their employer might think. Unfortunately, these fears might mean they miss out on the benefits they deserve. If you are owed money from the workers' compensation carrier, you can get legal help with your claim using a contingency fee arrangement. This allows you to be supported by legal help while your claim is being challenged. Speak to a workers' compensation lawyer about what you are owed and about contingency fee arrangements as soon as problems with your claim arise.

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