Does your workers’ compensation claim cause you difficulties?
The workers’ compensation system aims to protect injured employees but navigating the process presents numerous challenges and hidden dangers. Thousands of legitimate workers’ compensation claims receive denials annually since they contain basic errors which could have been prevented.
Any minor mistake in your workers’ compensation claim can trigger delays or result in less benefits and possibly total denial. The stress of an injury coupled with lost wages makes bureaucratic red tape blocking your benefits unacceptable.
What You’ll Discover:
- Not Reporting Your Injury Promptly: The Clock Is Ticking
- Failing to Seek Medical Treatment Promptly
- Giving Recorded Statements Without Legal Advice
- Failing to Document Everything
- Returning to Work Too Soon
Not Reporting Your Injury Promptly: The Clock Is Ticking
The most serious error injured workers make involves delayed reporting of their injury.
Workers must comply with strict state deadlines for workplace injury reports because failing to meet these deadlines can destroy your claim. The standard reporting deadline for workplace injuries to employers in California stands at 30 days.
But here’s what many people don’t realize…
Reporting your injury within the legal timeframe does not prevent employers and insurance companies from becoming suspicious if there is any delay. Authorities could question your reasons for not reporting right away or whether your injury actually happened at work.
To avoid this mistake:
- When you sustain any workplace injury you should tell your supervisor about it straight away regardless of injury severity
- Keep a record of both the individual to whom you reported your injury and the date it was reported.
- Submit a written notification to confirm your verbal injury report.
- Always maintain a duplicate record of every injury report and correspondence you receive.
Workers’ compensation premiums reached $43 billion in 2023 which represents an increase from the $42.5 billion tallied in 2022 and accounts for 5% of net written premiums in the Property & Casualty sector. Insurance companies examine every claim in detail because the financial stakes are very high. The workers comp lawyer in Fresno assists injured workers to understand the complex system and stop their claim from being unfairly denied.
Failing to Seek Medical Treatment Promptly
It is highly detrimental to postpone medical treatment following an injury.
You may delay medical treatment because you believe your injury will heal naturally, you wish to avoid missing workdays, or you underestimate how serious your injury really is.
The delay between sustaining an injury and seeking medical treatment can create an issue that significantly harms your compensation case. Insurance adjusters often claim that a genuine injury would lead to immediate medical consultation.
To avoid this mistake:
- Always get medical treatment right away following any work-related injury.
- Your healthcare provider needs to know that your injury occurred while you were on the job.
- Follow all treatment recommendations precisely
- Document every medical appointment and treatment you receive
Giving Recorded Statements Without Legal Advice
This error can cause significant harm to your workers’ compensation claim.
Following your workers’ compensation claim submission, your insurance provider may request that you give a recorded statement regarding your injury. Insurance adjusters learn techniques to ask questions that confuse claimants and elicit statements that insurers can use against the injured worker.
To avoid this mistake:
- Wait for a workers’ comp lawyer’s guidance before agreeing to provide a recorded statement.
- When providing a statement you must adhere strictly to factual information and refrain from speculating.
- Never downplay your symptoms or pain level
The 3.8% annual increase in civilian worker compensation costs for the period ending December 2024 prompts insurance companies to heighten their cost control efforts.
Failing to Document Everything
Your workers’ compensation claim depends heavily on documentation.
Injured workers often neglect to maintain detailed documentation of their injury along with treatment information and claim communications. Insurance companies find opportunities to exploit workers’ compensation claims when injured workers neglect to document their cases fully.
What should you be documenting? Everything related to your workplace injury:
- Capture photographs of your injury and the accident site whenever you can.
- Names and contact information of witnesses
- All medical reports and bills
- Work restrictions from your doctor
- Keep a record of your pain severity and functional limitations in a journal.
Returning to Work Too Soon
Although the desire to resume work quickly is natural, workers should avoid returning prematurely because this can lead to significant errors.
Injured employees often feel forced to resume work before full recovery because they worry about their finances or job security and face employer demands.
Returning to work prematurely before medical clearance can make your injury worse and result in a treatment gap while risking early loss of benefits.
To avoid this mistake:
- Do not resume work until your doctor releases you to do so.
- Get any work restrictions in writing
- You must follow your work restrictions completely without exception.
Accepting a Settlement Too Quickly
Workers frequently express shock when they receive immediate settlement offers from insurance companies.
Although accepting immediate settlement offers seems attractive for moving forward with life, it usually leads to financial loss. When you receive a settlement offer from an insurance company it will usually be well below the true value of your claim.
To avoid this mistake:
- Always ensure you comprehend the full extent of your injuries before agreeing to any settlement.
- Confirm that you have reached maximum medical improvement (MMI) before making any settlement decisions.
- It’s important to track every expense you have now and any medical costs you will face in the future.
- Seek advice from a workers’ comp lawyer prior to agreeing to any settlement offer.
The workers’ compensation insurance segment delivered strong performance throughout the last decade with a combined ratio of 91% between 2015 and 2023 before declining to 88% in 2023.
Not Getting Legal Help When Needed
Injured workers often attempt to navigate their workers’ compensation claims independently because they mistakenly assume the process will be simple.
Big mistake.
Simple claims with minor injuries usually progress without problems but complex claims tend to encounter difficulties. Handling a workers’ compensation claim by yourself presents significant risks if your case includes severe injuries, disputed claims, pre-existing conditions or employer retaliation.
Insurance companies use teams of lawyers and adjusters to work against your best interests and keep your compensation payments as low as possible. When you lack appropriate legal representation your chances of success decrease significantly.
To avoid this mistake:
- It’s essential to seek the advice of a workers’ compensation attorney at the beginning of your claim process.
- Make sure to engage a lawyer if your workers’ compensation claim faces denial or dispute.
- Most workers’ comp attorneys operate under a contingency fee arrangement which means their payment depends on winning your case.
Wrapping It Up
Workers’ compensation claims contain multiple obstacles that can disrupt your benefits during critical times.
When you avoid these frequent errors you improve your chances of getting the full benefits you deserve. Let’s recap:
- Report injuries immediately
- Seek prompt medical treatment
- Be careful with recorded statements
- Document everything thoroughly
- Don’t return to work too soon
- Evaluate settlement offers carefully
- Get legal help when needed
Any Fresno resident handling a workers’ compensation claim should seek immediate representation from an experienced workers’ comp attorney to safeguard their rights and ensure full benefit recovery.
