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Tips For A Successful Worker’s Compensation Claim

Last updated on December 9, 2022

An employee injured in the course of their work is entitled to workers’ compensation benefits to cover lost wages and medical expenses. Depending on the nature of the injury, workers’ compensation claims can be very expensive for insurance companies. These companies have a variety of tactics to avoid paying an injured worker’s claim or decrease the amount of compensation they are required to pay. The Delaware County Certified* Workers’ Compensation Lawyers at Schmidt, Kirifides & Rassias want all injured employees to get the compensation they deserve and encourage them to follow the below tips.

Report The Injury Immediately

A work injury should be reported as soon as it occurs, particularly if it may affect an employee’s ability to work. Workers’ compensation laws require injuries to be reported within 21 days, but employer and insurance companies may have their own policies that could effect the employee’s rights and duties. Reporting the injury to a superior immediately increases the chance of the claim being accepted, rather than disputed. A delay in providing Notice to the employer may cause them (or the insurance company – or even the Judge) to doubt the incident happened at work, or at some other time and place. Delays can result in witnesses forgetting what they saw, or you forgetting who the witnesses even were, and allows evidence to be destroyed or altered – even unintentionally. Injured employees must provide all of the relevant details regarding how the injury occurred. Not all injuries are caused by an ‘accident’; repetitive movements and activities can stress a particular part of the body over time, or aggravate a pre-existing medical condition. Once you learn a condition was caused or aggravated by your work duties, it must be reported timely.

Seek Medical Attention

Getting medical attention immediately after suffering a work related injury is important for several reasons. First and foremost, the sooner you get treatment, the sooner you may start on the road to recovery. Second, a delay in treatment is another reason that causes insurance companies to deny claims – challenging whether it happened at work, or at some other time and place. Should your claim need to be presented to a Judge for consideration, a delay in treatment may be viewed as the incident being minor, and pursuing a claim an afterthought. Go to an Emergency Room for severe injuries, or to an Urgent Care or Occupational Health clinic. Make an appointment to see your Family Doctor as soon as possible if the injury does not require immediate attention. Report EVERY area that hurts, or even just feels ‘unusual’. If you focus only on the most significant injury or area of pain, other areas that you report later may be considered unrelated to the work incident – because they are not documented in the medical records. You must also provide a thorough description of where and how the incident occurred.

Be Thorough And Consistent

The insurance company, their lawyers, and even the Judge will carefully compare what you report at every stage in the process – whether it is a police report at the scene of an accident; the employer’s incident report; in the Emergency Room; a recorded interview with the claims representative; and each and every follow-up medical report. Any inconsistency could result in the denial of your claim. Even if you told one supervisor or doctor ‘your story’, give every other person the same, detailed description. If three different doctors examine you in the E.R., give them each the WHOLE story, and report EVERY injury. You never know who might write down only part of what you said. Two different versions will seem worse to a Judge than multiple detailed versions.

Follow Through On Treatment

This advice is much like #2. Following through on treatment will help you recover sooner and more fully. Stopping treatment against medical advice because you ‘feel better’ may result in a set back or recurrence, because your body was not fully healed. Also, an insurance company may challenge your claim, or the duration of your disability if you skip medical appointments. A Judge may find your injury is not very severe if you didn’t feel the need to get ALL the treatment the doctors ordered.

Hire The Right Lawyer!

An insurance company may ask injured employees to take additional steps to legitimize their workers’ compensation claim. They may want a Recorded Interview, have you see “their doctor”, or sign authorizations to get medical and other records. Some of these steps they may be entitled to. Some of these steps you may have a duty to cooperate with. Others may be solely for their designed strategy to deny your claim. Unless you have a CERTIFIED WORKERS’ COMPENSATION SPECIALIST* by your side, you may not know your actual rights and duties. A truthful, innocent mistake can mean the difference between receiving benefits, or getting nothing.

Call Today For Help With Your Workers’ Compensation Claim

We will help you get all the benefits you are entitled to by law. Send us a message online or call our office by dialing 610-601-5399.