You make your way to another part of the warehouse, ready to complete the next task on your day’s to-do list. However, all of a sudden, you trip over a pallet.
The next thing you know, you feel excruciating pain in your right knee. You know there’s no way you’ll be able to go back to work today. Or anytime soon, for that matter.
You’ve just become one of the nearly three million people who suffer non-fatal on-the-job injuries each year.
Fortunately, you can take advantage of workers’ compensation insurance coverage. But how do you file a workers’ comp claim?
Here’s a rundown on the top mistakes to avoid when filing a workers’ comp claim.
Let’s dig in!
Mistake #1: Not Reporting Your Injury Quickly Enough in a Workers’ Comp Claim
When it comes to filing a workers’ comp claim, you have only so much time to get it done. The longer you wait, the harder it will be for you to obtain the benefits to which you are entitled.
Why? Because first off, you might miss your claim filing statute of limitations. Second, delaying your filing might make it look as though your injury isn’t as serious as you say it is.
In light of this, it’s critical that you report your workplace injury to your employer as soon as possible after it has happened.
Your employer will likely ask you to fill out a report on the incident. In addition, they’ll give you the information you need to start filing a compensation claim right away.
Even if your employer doesn’t require you to complete a report, you should still report the incident in writing. This will create a clear notice and timeline of your work-related injury.
Mistake #2: Communicating with the Third-Party Administrator
Once you’ve been hurt on the job, you may want to take the workers’ comp claim process in your own hands. And this may mean calling your employer’s third-party administrator, or TPA.
The reality is, the TPA is focused on protecting your employer’s interests over yours. The employer is their client after all.
Your employer would like to decrease their level of financial responsibility when it comes to your case. And they’ll utilize any details they can find to make this happen. So, if you talk to your employer’s TPA, the TPA can easily use what you share with them against you to the benefit of your employer.
For this reason, it’s best that you avoid speaking with the TPA, even if their representatives seem non-threatening and friendly. If you do have to talk to them, share with them only basic details regarding your situation. These include the following:
- Where and when your injury occurred
- Which body parts were harmed
- Who witnessed your workplace accident.
Avoid making any comments about your emotional or physical state since the accident. Also, don’t make comments about any past injuries you’ve suffered.
In addition, try not to sound too hopeful when you speak with the TPA. This is especially critical if a physician hasn’t cleared you yet and you aren’t totally healed from your accident injuries.
For instance, you may be tempted to say, “I think I’ll be able to get back to work quickly.” Unfortunately, the TPA may use this as an excuse to deny your workers’ comp claim. In this situation, if your condition worsens or persists, you’re out of luck.
Mistake #3: Not Tapping into the Expertise of an Attorney
Like many other injured employees, you might be reluctant to hire a workers’ comp lawyer. For instance, maybe you don’t think you need one.
It’s true that certain simple cases may be easy for you to handle by yourself. However, even in a seemingly simple case, a lawyer can make sure that you receive the maximum amount of compensation to which you’re entitled.
A workers’ comp attorney understands your rights in workplace accident situations and also know how to negotiate with TPAs and employers.
On top of this, many attorneys won’t require you to pay any fees until and unless you are successful in your claim.
Mistake #4: Completing Documents with No Attorney Present
This commonly made workers’ comp claim filing mistake is strongly linked to the previously mentioned mistake of not hiring an attorney.
As a general rule of thumb, you should never sign a document until you have had an attorney review it first.
Let’s say you decide to accept a particular insurance settlement offer. However, later on, you realize that this was a bad move.
At this point, it’s too late. Once you agree on a settlement, your claim will be closed, and you won’t be able to revisit it.
Unfortunately, many TPAs aim for extremely low and quick settlements. But that’s why you need to have an attorney review any settlement offer or other important document before you sign on the dotted line.
An experienced lawyer will advise you on how to obtain the amount you’re entitled to, which may be much higher than you anticipated.
Mistake #5: Neglecting to See a Doctor
Another commonly made mistake when it comes to filing a workers’ comp claim? Failing to seek medical care after your workplace accident.
The point of benefits from workers’ compensation insurance is to treat your injuries so that you can recover from them. If you fail to seek care, it will look as though you didn’t actually develop an injury.
Also, when you do see a doctor, be sure to follow their prescribed plan. If you don’t do this, your employer’s TPA will view this in a negative light.
If you don’t need any treatment or apparently haven’t suffered any injuries, the TPA will probably say that benefits aren’t warranted in your case.
Mistake #6: Neglecting to See Your Employer’s Doctor
In addition to seeing a doctor, it’s paramount that you see the doctor that your employer provides for you.
According to the law on workers’ compensation, the workers’ comp insurance company or your employer is allowed to select a doctor to treat your work-related illness or injury. This doctor will assess your situation, provide you with the right therapy, and produce reports related to your claim.
If you refuse to see the doctor whom your employer appoints, your claim could easily be dismissed. However, you could see your personal physician in addition to seeing the employer-appointed one.
Also, if you are not satisfied with the appointed physician, you can always ask your employer’s workers’ comp insurer if you can see a different doctor. Fortunately, you can find a number of leading workers’ compensation injury doctors at workers comp doctors.
However, let’s say that the insurance company won’t be flexible in accommodating your request for a new doctor. In this scenario, you could fill out a Form 50, where you’ll request to undergo a hearing in front of a workers’ compensation commissioner.
Mistake #7: Taking Too Low of a Disability Rating
Perhaps your doctor is finished treating you because they feel that you’ve recovered as expected. At this point, they’ll give you a type of disability rating.
This rating plays a major role in your workers’ comp settlement. So, make sure that your doctor doesn’t give you too low of a rating. This could lead to less compensation than you’re entitled to.
Mistake #8: Being Dishonest
You may be tempted to tell some white lies when you file your workers’ comp claim. You think that perhaps this will increase your chances of getting your claim approved.
However, the benefits you get will be dependent on the reports that your doctor produces. Your doctor will have a good idea if you’re exaggerating about your health condition.
So, be honest about your workplace accident, the injuries you suffered, your recovery process, and any setbacks you experience. If you lie about your injuries and the TPA figures this out, your claim will most likely be denied.
How We Can Help
In addition to highlighting the top mistakes made when a workers’ comp claim is filed, we offer a wide range of other tips and advice related to work and productivity.
For instance, on our site, you can find out about how to become your own boss. In addition, you can find out about how to expand your presence online with the top marketing tips.
We also discuss how to create a plan for a business — for example, a construction business — as well as how to handle a business after you’ve suffered injuries in an accident.
Take a peek at our website to find out more about how to become more effective and find more fulfillment in the business world.