Tips To Help You Understand Complex Worker Compensation Claims


Injuries happen when you least expect them and unfortunately, according to national statistical data, many people get injured at their workplace. In many cases, things are getting really complicated for victims as they have to fight for the benefits and compensation they deserve. Some worker compensation claims can be incredibly complex and many people just do not know where to start and how to handle the challenging situation. If your case fits the description, here are useful tips to help you understand your claim and get the best possible results.

Report Your Injury Instantly

No matter the circumstances, the first thing you should do is to report your injury to your boss or any other person who is in charge. Deadlines for reporting the accident may vary greatly from one state to another, however, the rule of thumb is not to waste time unless you are not interested in receiving your benefits. Make sure everything is in the letter and officially registered in accordance with the rules.

Never Refuse Medical Help

Even if you feel fine immediately after the injury, do not refuse medical help. In the words of Attorney William F. “Trey” Underwood, author of “Common mistakes that can destroy your workers’ compensation case” and founder of PuttingPeopleFirst, such behavior can cost you dearly later. The insurance company is likely to argue that your injury wasn’t serious – indeed, why didn’t you seek medical treatment if you were injured? Plus, getting professional help immediately after the accident boosts your chances to recover quickly and avoid unpleasant complications.

Think Of Changing The Doctor

Let’s face it, the majority of doctors that provide initial treatment to the injured workers are chosen and paid by insurance companies, therefore do not be surprised if your doctor is trying to make your injuries look less serious and your pain less intense. Unless you live in a state that lets workers choose the doctor from the very start, consider checking out the specific procedures for doing it in case you feel you and the doctor have different views on the situation.

Watch Out Eventual Surveillance

Despite what you may think, private investigators do not belong to Hollywood thrillers only, they are a normal part of the insurance business. In case of complex and hefty claims, insurance companies do hire them to catch the victim lying about the severity of the injuries and eventual disabilities. Keep in mind that your everyday life can be under surveillance and do your best to act accordingly because the worst thing you can do is to unintendedly provide them a reason to state that your condition is actually much better than you say.

Fight For Your Rights

Insurance companies are hard to deal with, especially without a competent attorney on your side. However, you should know that if your compensation claim was denied, it is not because you do not have the right to compensation but because insurance companies like to deny claims – this way they try to save money. So, instead of just giving up, take advantage of your other right and appeal the denial of your insurance company. Fighting for your rights always pays off, so consider all the available options and if necessary consult an injury lawyer, all the more so, the initial consultation is usually free.

Be Ready For IME

Short for Independent Medical Examination, IME is something you should be ready for if you and your insurance company are not really on the same page when it comes to the size of your worker benefits. Make sure to get ready for this important appointment chock-full of tricky questions because it will affect what is coming next. Just a heads up, do not try to avoid your scheduled IME since you will give the insurance company the grounds to terminate your benefits. Instead, think of your previous medical records, diagnoses, conditions, work restrictions, and everything else that may help you get an advantage.

Know Your Workers’ Comp Benefits

Even though the availability and size of benefits provided by the workers’ comp system differ from state to state, normally, injured workers are eligible for both temporary and permanent disability benefits, as well as compensation for medical expenses (treatment of injuries, rehabilitation to full recovery) and expenses related to travel to and from various appointments. The best way to learn the benefits system in your state is to contact the respective authority or a lawyer.

Of course, there is no one-size-fits-all advice when it comes to complex worker compensation claims and every case should be carefully considered on an individual basis. However, understanding the matter and knowing your options can help you make the right choice and get the compensation you deserve.


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