What to Do When Employers or Insurers Fight Workers' Compensation
If you're ever injured on the job, it's likely that you're entitled to workers' compensation benefits. In fact, the rules are set up so that, even if you are hurt at work due to your own mistake, you can still receive compensation. Of course, it doesn't always happen like this since employers and insurers often fight against these benefits. Fortunately, there are steps you can take if you're unfairly being denied workers' comp.
Why Would I Be Denied?
If you're ever denied workers' compensation benefits, you will be informed of the reason for that denial. Keep in mind that there are a variety of reasons that your claim may be denied. And even if you disagree with the reasoning for your denial, it's important to remember that there are often different interpretation of what's right. Accident victims and insurers often see the same situation through different lenses, so whereas you might see a permanent injury, they may only see a five-month loss of work.
Of course, some workers run into issues before even dealing with the workers' comp insurer. You and your employer may also see things in a different light. An on-the-job accident will result in their insurance rates going up, so they want to be absolutely certain that an injury occurred during the course of employment.
While this may seem like your employer being difficult, it's not unreasonable for them to question claims. Tens of billions of dollars are lost to workers' comp fraud every year. Your employer may just want to avoid becoming part of that statistic.
Fighting Workers' Comp Denials and Other Issues
Many people think that a denial or pushback from their employer is the end of their workers' comp case. The belief that the law will immediately side with the "big dog" is prevalent. Fortunately, this isn't the case. In fact, California recently investigated one of its southern counties over their workers' compensation tactics.
When you're hurt on the job, the law is on your side, and while state laws may differ, they're all geared towards helping injured workers. If you're injured at work in Sacramento, for instance, your employer is supposed to provide you with the Workers' Compensation Claim form. In a situation with this amount of initial pushback, though, it's probably a good idea to speak with a Sacramento workers' compensation attorney.
If it's the workers' comp insurer giving you issues, though, there are other considerations. The first thing to know is that a denial isn't the end of the story. You have the option of appealing the decision. Again, an attorney would be helpful in this instance so they can help you through the entirety of the appeals process.
Increasing Your Chances of Receiving Benefits
While unfair insurers and employers may try to prevent workers from receiving benefits, there are a few things you can do to make it more difficult for them. In many states, ranging from California to the East Coast, you can lose your right to receive benefits if you don't promptly report your injury. Your employer or the insurer can later say the injury may not have been sustained on the job, so report it immediately and keep that "easy out" away from them.
Next, you'll want to follow all rules related to receiving benefits. Your employer, for instance, may require you to be treated at their own Health Care Organization (HCO) unless you already designated a particular physician. Lastly, you will want to seek out the help of a workers' comp attorney at the first sign of trouble. There are typically deadlines for applications and appeals, so you don't want to waste time when it comes to being financially compensated.
Getting injured on the job can be a disheartening and financially stressful situation, but this becomes much worse when there are people working against you. Fortunately, there are ways of getting around this, so never forget that the law is on your side.