10 Mistakes to Avoid in Workers’ Compensation Claim

10 Mistakes to Avoid in Workers' Compensation Claim 

Workers' compensation claims are supposed to help employees who get injured on the job. They replace the employee's lost wages and medical expenses while they recover.  

However, the process is very complicated, and any mistake may lead to delayed payment, reduced benefits, or even refusal of the claim.  

Whether this is your first time or you have been through the process, knowing the common mistakes is important to ensure a smooth experience. 

This article will discuss the ten common mistakes that one should avoid when processing workers' compensation claims.   

1. Compensation Claim: Failure to Seek Legal Advice When Necessary

Workers' compensation is very tiresome, especially when your claim is disputed or denied. Most workers need assistance with these issues.  

A Workers' Compensation lawyer can help you negotiate with the insurance company, appeal denied claims and explain your rights. So, if you experience any difficulties through the claimant process, speak with a lawyer, as this ensures that your case is taken care of correctly. 

However, always ensure you hire a local attorney, as they know local laws in and out and have relevant connections with various experts that you might require during the process.  For example, if you live in Raleigh and want to file a claim, hire the best Raleigh Workers' Compensation Attorney.  

2. Failure to Report the Injury in Time

One of the common mistakes you can make is to report your injury after some time.  

Most workers' compensation laws dictate that an employee needs to notify the employer within the required time in case of a workplace injury. Delays raise doubt on whether it happened at work, which makes it hard to process the claim. 

Long delays raise questions with your employer or his insurance company over the viability of your claim.  

3. Not Seeking Medical Help Immediately

Most workers underestimate the seriousness of their injuries and fail to seek medical care immediately. This weakens your claim since insurance agents may argue that the injury was mild or work-related. 

Medical records are proof to back up your claim, and if you delay treatment, then you have gaps in your medical history, which makes it hard to prove that it was a work-related injury. 

4. Failing to Follow Employer-Designated Healthcare Protocols

Workers' compensation laws require that you see the employer's doctor or their insurance carrier's choice for an initial consultation. You must do so to ensure your claim is valid. 

If you visit a doctor that is not approved by your employer and without proper authorization, your claim or medical expenses may not be allowed. 

5. Compensation Claim:Providing Conflicting Information

Contradictions raise red flags. If you tell your employer one story about an incident and another from your doctor, that may raise some skepticism. 

The insurance company will usually look for any reason to deny your claim; inconsistent information is considered dishonest. Be clear and consistent with the description of your injury, and keep a written record of all the details, such as the date, time, and narrations of how it occurred. 

6. Not Giving Enough Importance to Documentation

Keeping detailed records of your injury, treatment, and correspondence with the other parties will be important to the validity of your claim. 

If there is a dispute, documentation is your evidence. Make a copy of all your medical records, injury reports, correspondence regarding your claim, and a personal diary regarding your recovery and the challenges you experience in your work due to the injury. 

7. Assuming All Workplace Injuries Are Covered

Not every work-related injury is covered under worker's compensation. For instance, injuries while horsing around, while violating safety rules in the workplace, or being under the influence may not be covered. Understanding what is covered under workers' compensation will save you from disappointments or legal troubles. 

8. Returning Too Quickly to Work

Employees often hurry back to work to satisfy their employers or out of fear that they may lose their jobs. Returning to work before fully recovering complicates your claim and aggravates the injury. 

If you return to work too quickly and your injury worsens, it may not be part of your original claim. Furthermore, if your employer pressures you to do light-duty work, ensure the work suits your physical condition and your doctor's recommendations. 

9. Trusting the Insurance Company Without Question

Remember, the workers' compensation insurance company is not your friend. They have one primary objective: to minimize payouts by denying or lowballing a claim. Taking the first assessment given to you by an insurance company without question can leave you with the burden of medical expenses and lost wages.  

Go through the documents carefully and ask for explanations of what you need help understanding.  

10. Failure to Follow Medical Advice

You risk your claim by not attending any doctor's appointments and not taking any prescribed treatments to protect your claim. Following medical advice means that you are serious about recovery.  

If you fail to follow through, it will result in reduced benefits or denial of your claim. Insurance adjusters might argue that you are not as injured as you claim if you do not follow through. 

Bottomline 

Filing the workers' compensation claim is a major step in getting the help one needs after injury. Knowing how to avoid common pitfalls is as important as filing a claim. Every step you take, from promptly reporting your accident to keeping thorough paperwork and following medical advice, can have huge implications regarding the outcome of your claim. 

Workers' compensation provides for the employee but can be a bit difficult to use at times. Being properly educated and prepared helps you breeze through the process and receive the compensation you deserve.