Posted by Gary Burger on February 22, 2017 in Workers' Compensation
9 Most Commonly Made Mistakes When Filing for Workers Compensation
Anytime an employee is injured in Missouri or Illinois they are entitled to Workers Compensation benefits.
Here are the top 9 mistakes:
- Waiting to tell your boss. If there is any chance you are injured in an accident, tell your boss, supervisor or the appropriate person right away. File an injury report. Get medical care. Do not be afraid of retaliation and don’t be afraid to report the injury. Responsible employers want their employees to get healthy and back to work. Unscrupulous employers violate the law if they fire you in retaliation for making a work comp claim or being injured on the job. If you don’t report it, you will be challenged later on whether or not that injury ever occurred. You have two years to file a claim in a work comp, but you need to report that injury right away. If you don’t report it you can’t validly assert that they should have paid your medical and paid you temporary total disability while you are off.
- Not filing a written injury report. You need to file a written injury report. Send an email confirmation of it. Fill out the paperwork at the work comp doctor’s office or the urgent care or wherever you are being treated and say that it is a work-related injury. Do not go to the hospital and tell them that you injured yourself at home or deny that it is a work comp injury when it really is. Fill out the accident or injury report, keep a copy for yourself, list the witnesses to the accident and keep a separate piece of paper or you have the names, phone numbers and contact information of the witnesses. Attached hereto is Exhibit A is a sample of an injury report form.
- Deny the accident occurred or downplay it for the good to help your employer. The truth will set you free. Always communicate and be clear about how the accident took place and how bad your symptoms are. If your employer is trying to keep it off the books and pay for your medical with cash or put it on your health insurance, it is improper, and they are going to hurt you. They are going to use this to deny that you ever had an accident in the first place. We have had many instances where employers talk their employees into putting the medical treatment on their health insurance, so they don’t have a reported workplace injury. Then, years later when the employee is permanently disabled or needs surgery, they deny the accident ever occurred and deny the work comp benefits. Employers can have pressured to keep accident free days and have good safety, but that is only for some corporate bottom line. If you are injured, report it. Many times companies make that up issue to put pressure on employees not to report injuries. This is illegal to do and unfair. They are only trying to hurt you.
- Not getting medical care. Get medical care right away. Go to the emergency room, urgent care, or primary care doctor and report the injury and get the medical care that you need. You have insurance and your health is important to you. If you don’t seek treatment right away, your employer and insured are going to try to say that it is because you weren’t hurt. A medical visit will always be paid by your work comp injured, or we will sue until they do. Do not delay and go get the medical care you need right away. Try to keep all your appointments and get follow-up medical care with the company doctor, physical therapists, tests and anything else that is required. Employers and insured love to use missed appointments to deny further medical care. This creates a good record for you in the ultimate claim for temporary, total, or permanent disability.
- Not talking to a lawyer. Talk to a lawyer before things get too far. Sure, if you have a minor injury and get some simple care you may not need a lawyer. However, employers will not tell you that you are entitled to a lump sum disability at the end of the case. Even after all of your medical care is paid, your employer pays 2/3 of your wages while you are off work; you are still entitled to a disability claim at the end of the case. That is the only amount that lawyers should never take a fee on. They should never take a fee on your medical care, TTD, or PTD unless it is a hardship hearing. So, talk to a lawyer to make sure that you are getting all the medical care you need, that you are fully paid for your time off, and that you can make sure that you get full payment for your temporary total disability or your permanent disability award. Workers’ Compensation benefits are already cheap and underpay employees for what they go through and Workers’ Compensation doesn’t pay for pain and suffering which is very real and tangible. So, the minimum you can do is to make sure that you talk to a lawyer to ensure you get full compensation under Workers’ Compensation rules. Remember that even though you may hurt limited part of your body, it may affect your body as a whole. Attached hereto as Exhibit A is the Workers’ Compensation chart for measuring disability levels.
- Trusting the company doctor. The company doctor is there to minimize your injuries, give you minimal medical care, and release you back to work as soon as possible. There are certainly good doctors out there that look out for their patients. However, workers compensation insurance companies will only continue to use doctors if they play the game for the employer and the insurance company. This works to the disadvantage of the employee. However, employers are entitled to control the medical care and control who you go to, so you got to go to them. But, make sure that you are a good advocate for your problems. Make sure that you tell the doctor about all your pain and symptoms and make sure that you ask for tests, consult with your attorney to make sure that record is being clearly made in the doctor’s file. Hand write a note after your doctor’s appointment about everything you told the doctor – the odds are that what you say happened will be different than what the doctor’s notes say. Make continued complaints, send emails or communicate in writing to your nurse case manager or the employers’ doctor about the symptoms you are going through and what is going on. Be kind but persistent. There is no reason to create and adversary relationship with a doctor, nurse practitioner or a claim representative. At the same time, you don’t want to roll over and have your rights trampled upon. If this game starts getting played, it is even more important to get a lawyer.
- Accepting too little compensation for your disability at the end of the case. As stated above, you’re entitled to a permanent total or temporary total disability award. Too often, injured workers take too little for this. A good lawyer will advocate strongly and make sure that the employee is being adequately compensated for all the levels of disability relating to the claim. Further, a good lawyer knows how to make sure that all aspects of the work related injury are taken into account, disfigurement, limps, and mental health issues that are associated with the injury. It is important to get a clear view of the full extent of injured workers damages. That is why we send all of our workers’ compensation clients to the right doctors who can evaluate them and have good advice about the full extent of the injuries. This enables us to maximize the disability payment at the end of the case. We also want to make sure that if the company doctor is missing anything, our doctor makes sure that all conditions are being treated for and insure that you get to your maximum medical improvement as soon as possible.
- Being inconsistent or not credible with complaints. Make sure that your reports of pain are consistent with the same parts of the body. Make sure that you continually relate how the incident happened and don’t deviate from what occurred. Make sure that you don’t complain to a doctor of excruciating pain on the same day you post on your Facebook page that you are pain-free and going for a 20-mile bike ride. Be specific about your injuries, what you can and can’t do, and what hurts. Sometimes insurance companies even go spy on workers/employees who say that they are completely incapacitated to try to show that they are liars. Don’t get caught in this game. Don’t exaggerate but be clear about what happened.
- Don’t be afraid to talk about all of your pain and suffering and even mental health issues. Many injured people don’t want to reveal the full extent of their pain, stress, anxiety, or mental health issues relating to an injury. This is a mistake. Males tend to be too tough and not want to sound wimpy, and females tend to want to be strong for their families. These intentions are very good, however, when communicating about injuries to employers, insurers, and medical personnel, you need to be detailed, accurate and candied. Fully explain the nature of the pain and symptoms you are having. Fully explain the mental stress, depression, and other consequences of your workers comp injury. The doctor should treat you for this and provide you with the needed therapy and/or medication to help you recover. There is no reason why you should delay your full recovery by not disclosing mental health issues. There certainly is a stigma in our society about doing so, but don’t be afraid to overcome that. People experience post-traumatic stress disorder, anxiety, depression, and other conditions very often with work related injuries. These injuries are traumatic and affect your job and your ability to care for yourself and your family. It is not a sign of weakness that you want to get help and get better. Sometimes these are a result of chemical changes in your brain that you do not have control over. So, be candied and get counseling or medication to get better. This should be included in your work comp claim. We can get you additional medical care from these professionals and get you rated and get your mental health rated as part of your disability claim. But we can’t do that if you don’t make these complaints.
Conclusion, I hope that the information above has been informative and assist you in pursuing your claim. If Gary Burger can help you with your claim, call him at 314-542-2222, email him at email@example.com, or contact us on our website.