Complications With Workers’ Compensation Claims

One of the reasons that many states are taking action to reform workers’ compensation systems is that they are not always the most efficient. They can become unbalanced and not benefit those who they are meant to benefit in the way they originally intended to. Workers’ comp is supposed to provide quick financial aid to workers who are injured on the job and need medical treatment. Complications can arise when employers or their insurance companies are uncooperative, delay, discredit, or underpay your claim. You are entitled to benefits when you are injured on the job, so when complication arise, this can be discouraging. You should contact the Law Office of James M. Hoffmann to learn more about your rights and your options in Missouri.

You should be aware of what delays are to be expected and when a delay or issue becomes a larger problem that needs to be addressed by an attorney in order to be resolved.

Common Complications:

• Biased Independent Medical Examinations
• Intimidation Tactics
• Surveillance
• Intentional Delays

Biased Independent Medical Examinations

After reporting a workplace injury you will probably be expected to undergo an Independent Medical Examination. An IME is a medical exam from a doctor who is paid for by your employer’s insurance. You are not usually allowed to see your own doctor for a period of time. Requiring that you undergo an IME is supposed to prevent a doctor of your choosing coming to a diagnosis that is biased in your favor. However, many feel that IME’s have the exact opposite result, in many cases, where the doctor being paid by the insurance company is biased in favor of your employer.

You can ask for another doctor or you can ask to have your attorney present during your medical exam. This may result in a less prejudiced diagnosis.

Intimidation Tactics

Legally, you cannot be fired because you filed for workers’ compensation. An insurance company is also not allowed to harass, intimidate, harm, or coerce you in any way during the claims adjustment process.

Surveillance

Some insurance companies hire private investigators to surveil you as an attempt to discredit your claim. Investigators are looking for information that may harm your case, like you performing an activity that shows you are not actually injured in the way you claim to be.

Not every workers’ comp claim results in surveillance happening, but assuming there is surveillance even if there is none, will not hurt.

Intentional Delays

Some employers or insurance providers use the tactic of intentional delay. Usually once you report your injury, your employer must then report the injury to the insurance within a period of 7 days. If the employer fails to do so, they could face fines. Additionally, if you are supposed to receive disability benefits or other compensation and you are not paid within 7 days by the employer or insurance, they can be penalized for the delay.

The claims process in general can be lengthy, however, and is not always resolved immediately. You may be offered a lump sum settlement after some time goes by, and this can be tempting because you may just want to finally resolve the claim. But usually the settlement amount offered is not fair and will not cover your current or future medical needs.

Contact James M. Hoffmann – MO Workers Compensation Lawyer

by calling (314) 361-4300 or fill out our online contact form

Workers Compensation Claim