When The Workers' Compensation Insurer Won't Cooperate

Posted on: 14 July 2021

Hurt workers may be entitled to many benefits if their claim is approved. Unfortunately, workers who depend on those benefits can find that things don't go as smoothly as they might have hoped. Some workers end up fighting the workers' comp insurer, and that does not help an injury or illness get better. To find out more, read below.

Benefits You Hope to Receive

Workers' compensation is insurance paid for by your employer. You are covered from the time you begin your job for any work-related medical problems. That coverage usually includes (in the initial stage):

  • Medical treatment costs in full as related to the injury.
  • Partial wage replacement, usually paid weekly and may be about 66% of your previous wage.

The second phase of workers' compensation is reserved for workers with permanent injuries that are not expected to heal enough to return to work. The compensation for this phase may include a lump-sum settlement.

Problems With Benefits

Every hurt worker must file a claim in the appropriate manner and then wait for approval. They don't have to wait to get medical help, however — they are covered immediately for that. Unfortunately, hurt workers could face one or more workers' comp tactics that are meant to delay and dissuade workers from getting the benefits they deserve.

  1. Denying a claim due to minor errors on the claim form.
  2. Losing claim forms, sending them back to the employer for no reason, waiting too long to communicate with workers about the claim, etc.
  3. Alleging that the accident or injury was not work-related.
  4. Accusing the hurt worker of being under the influence of drugs or alcohol at the time of the incident.
  5. Claiming that the medical condition claimed was already present (preexisting).
  6. Denying claims due to lack of evidence or witnesses.
  7. Insisting that the worker returns to work even when they are still in pain and unable to do so.
  8. Threatening that the worker may lose their job if they don't return to work at once.
  9. Cutting off benefits for no reason.
  10. Being consistently late with weekly disability wages.
  11. Deciding that the worker is permanently injured but offering them an inadequate lump-sum payment.

You Have Rights So Use Them

Hurt workers are protected by a number of laws and regulations, but many don't realize it. If any of the above happens to you, you may need a workers' comp lawyer to help you protect your rights. For example, you have a right to a second opinion if you are told your injury is healed or is permanent. Also, you cannot be fired just for filing a claim. Don't ever just accept what the insurer says. Speak to someone who is on your side and will help you get the benefits you need.

Contact a workers' compensation lawyer to learn more.