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May 2018

Tips to Make Sure You Are Being Paid Your Workers’ Compensation Benefits

By | Workers Compensation

When you get hurt on the job, your injuries may last longer then you might have expected. It is important to make sure you are not wrongfully denied benefits to receive the maximum amount of compensation you can. Without legal representation, you are at the mercy of the insurance carrier and the adjuster who is handling your claim. Insurance companies may find ways to delay, limit, or even discontinue your benefits for many different reasons. Some adjusters do right by the injured employee by approving medical expenses and paying the correct benefits on time. However, sometimes adjusters hide information from you and will not tell you the whole truth about your claim. For example, do not ask an adjuster how much your benefit checks are worth, keep in mind that they are the ones who chose that amount.  The adjuster will tell you the amount you are receiving, whether or not it is the amount it should be. The only way to make sure you are receiving all of the benefits you are entitled to, is by speaking to an experienced workers’ compensation lawyer.

Here are some tips to follow:

Report the injury as soon as possible

According to workers’ compensation laws, you must report the injury as soon as possible or within the next 30 days. Some workers’ compensation lawyers may deny claims simply because the injured employee did not report the injury immediately. If you think you are unable to work the next day, report the injury to your supervisor as soon as possible. This will help better your chances of getting your benefits promptly. Your employer will also require you to fill out and sign an accurate accident report.

Write down the names of any witnesses

Witnesses are crucial in work related injuries to prove that you were actually hurt on the job. If anyone witnessed your accident, get their names and contact information. 

Get medical treatment

Make an appointment to see a doctor after the injury. Insurance companies like to assume that if you did not receive medical treatment, you were not hurt. Additionally, it is important to attend your appointments and follow up with the prescribed medication and treatments. If insurance companies notice a pattern of missing medical appointments they will assume you have recovered and will start looking for ways to terminate your benefits.

Explain in full detail how you got hurt

Insurance companies will deny workers’ compensation claims if your medical records do not adequately describe the accident and injury.  If you tell your supervisor how it happened one way but then tell your doctor it happened another way it will hurt your case.  Make sure your statements match up and stay consistent. By clearly explaining the injury to your health care provider, they are able to keep their records more accurate. You do not have to elaborate the injury in full detail, keep it basic so the doctor can write it down correctly.  Make sure you say that the injury happened at work. The insurance company may ask you to sign a limited medical authorization allowing them to receive copies of your medical records. This request is reasonable, however, they are only entitled to record and bill related to your work injury. You should not sign any other authorizations because insurers are not entitled to those records without discussing the them with a workers’ compensation lawyer. 

Attend All Scheduled Legal Proceedings and Appointments

Unless you have a workers’ compensation lawyer, you must attend every legal meeting or court date during an appeal. If you do not appear at one of your scheduled legal appointments, you risk losing your benefits.  Even if you have a lawyer, you will need to show up for key appointments such as your deposition and independent examination.  If you have to miss an appointment, you should notify your insurance company and state agency beforehand. 

Finally, talk to a workers’ compensation lawyer.

You may not need a lawyer if your workers’ compensation claim is very simple or if the insurance company voluntarily pays the claim.  Consider hiring an experienced lawyer to help you understand the benefits you should receive from your work related injury or if you are having trouble getting any information from your insurance company. 

If you have questions or think you may have a workers’ compensation case, you can always speak to one of the attorneys at Losi & Gangi. Call us at 716-854-1446.

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