An employee can file a claim for workers’ compensation benefits in California if he/she sustained an injury on the job or developed a work-related illness. All employers that have at least one employee in California are required to have workers’ comp insurance policies in order to protect workers in the event of a workplace injury.
In a lot of cases, submitting your workers’ comp claim in Oakland is a painless and hassle-free process, and your claim is often approved without issue. While workers’ compensation in California can pay for your medical expenses, rehabilitation, and lost wages, keep in mind that the insurance companies would try to pay you as little as possible.
Actually, these insurance companies hire medical experts and private detectives to determine whether your injuries are, definitely, work-related or not. Hence, they would leave no stone unturned to reduce or even turn down your workers’ compensation claim.
This is why without adequate preparation and reliable and experienced legal help, you’re more likely to make some rookie mistakes that can ruin your workers’ compensation claim. Here are some common missteps that can hurt your chances of recovering workers’ comp benefits.
Failure to Report Your Work Injury in Oakland
Reporting your work-related injury in Oakland to the employer as soon as possible in writing is crucial in your workers’ comp claim. Failing to report your work injury as soon as it happens may compromise your benefits. Make sure that you follow your employer’s policies and procedures for reporting and responding to workplace accidents. In California, you must file your workers’ comp case at your earliest convenience. One of the disastrous mistakes injured employees make is waiting too long.
Note that the time duration of each case is different. Although employers usually require a compensation claim within 24 hours, remember that the appeals board often has their specific statutes of limitations. After a certain time period, your compensation claim could be barred. Also, make sure that you save copies of the accident report as well as all documents related to the case.
Not Seeing a Doctor
If you sustain a work-related injury, then your top priority should be to seek medical attention. So, after you’ve reported your injury to your manager or employer, visit a doctor immediately. Note that when it comes to having your workers’ comp claim approved, you need to have credible proof of injury.
The proof comes in the form of various medical records. In case you file a compensation claim stating that you missed many days of work and lost your wages because of injury, but didn’t see a doctor during that period, then there’s a good chance that your compensation claim will be denied. Also, a fast diagnosis may improve the outcome of your treatment. On the other hand, if you delay a medical evaluation, it might not be easy to link your injuries to the workplace accident.
Being Dishonest About Your Injury in Any Way
You should be honest and forthcoming about your accident or injury with all parties, such as your supervisor, doctor, lawyer, and insurance provider. Keep in mind that exaggerating your injury in an effort to get higher benefits usually backfires and can result in a denied claim.
Also, downplaying your injury could result in an insufficient amount of compensation, and this can put you at risk of getting injured again.
Apart from hurting your compensation claim, making material misrepresentations in the compensation process can result in jail time and even court-mandated reimbursement for any benefits paid. Usually, doctors and medical experts associated with workers’ compensation providers try to downplay worker injuries for reducing the amount of compensation benefits they receive. So, when this happens, you should advocate for yourself and reiterate your symptoms and experiences to your doctor.
Usually, workers feel they always have to trust their doctors and accept their diagnoses, and this can create situations where employees allow doctors to state that their work-related injuries are less serious than they really are.
Not Following Your Doctor’s Orders
Workers’ comp benefits are meant to help you as you recover from an injury. This is why if you’re seen as standing in the way of your recovery, then your compensation benefits might be discontinued or denied. Insurance carriers and employers will contend that your medical and work benefits should be terminated if you do not follow your doctor’s advice.
In case you think that your doctor is not giving you the best advice, our workers’ compensation attorneys will seek to get you treated by another doctor.
Note that many employers tend to work closely with nurse case managers that will immediately inform your employer if you miss your appointments or do not follow their recommendations. It’s extremely important to keep all your doctors’ appointments while following your doctor’s recommendations for medical treatment as well as therapy.
Medical Record Discrepancies
The most common reason why an employee’s workers comp claim is rejected is because they’ve injuries that don’t match their employer’s recounting of events.
For instance, if a worker falls off a ladder and reports to their employer that they hurt their lower back and then visits the doctor and instead reports that their ankle or leg is what’s hurting them, this could negatively impact their compensation case.
In most cases, insurers will see this as a red flag and can be suspicious. They can deny your claim if they believe that you are making a fraudulent claim. You should avoid this risk by being honest and straightforward throughout the whole process and fully explain any discrepancies to the relevant parties.
Bragging On Social Media
This is another mistake that many workers make. If you’re injured on your job and have filed your workers’ comp claim, the insurance company would investigate your claim in order to make sure that you’re not exaggerating your injuries. In this regard, one of the simplest ways to look into your claim is to go through your various social media accounts for any evidence that may weaken your claim.
So, posting pictures on social media showing yourself engaged in a physical activity, like dancing at a dinner party or driving a vehicle when suffering excruciating pain would allow the insurer to accuse you of exaggerating the injuries. In contrast, bragging about the amount of money you could receive from your claim will definitely make the defense question your motives for filing the claim. For better or worse, appearances are everything when it comes to social media.
So, keep in mind that the defense could misinterpret even a few seemingly harmless posts and use them against you. It’s, therefore, better that you stay away from social media during your claim process.
Not Requesting A Second or Third Opinion
You have the right to disagree with your physician’s diagnosis or treatment plan for your work injuries. It is worth mentioning that many injured workers are not aware that they’re entitled to get a second opinion and even third opinion from other healthcare professionals within their medical provider network.
And, if you still disagree with your diagnosis and treatment after getting a third opinion, then you have the right to request an independent medical review (IMR).
Not Returning to Work on Light Duty
At times, the doctor who is treating you might determine that you’re well enough and can go back to work for a set amount of time performing light-duty tasks. In case you do not return to work on light duty as recommended by the doctor, your employer would have reason to believe and argue that you’re taking advantage of time off and even falsifying the severity of the work injury.
So, it’s always in your best interest that you return to your workplace on light duty when the doctor releases you to do so. Document any discomfort or pain that you experience when performing light-duty work. In case you feel you’re not physically ready to resume work, even on light duty, you should return to the doctor for further evaluation.
Signing Documents without a Workers’ Compensation Attorney Present
Remember that once you sign your name on any settlement offer, you will not be able to revisit your claim if your work injury never heals or the amount of the settlement does not cover all the costs of your expenses.
Keep in mind that the insurance company is looking out for the best interests of your employer, not yours. So, ensure you have a competent lawyer present when you are signing documents to make sure you’re getting the best deal.
Not Consulting a Workers’ Compensation Attorney
Many workers are hesitant to talk to a workers’ compensation attorney regarding their claims. Some tend to worry that they will end up with less money by hiring an attorney. Although an attorney will indeed get a certain portion of your claim settlement, it is also true that a competent and experienced lawyer can considerably increase your benefits. Note that represented employees almost always get more money even after the payment of legal fees.
A lawyer can also advocate for you during interactions with both employers and workers’ comp providers, securing suitable compensation for you while you focus on your physical recovery.
Conclusion
The best way to steer clear of these costly mistakes and missteps is to speak with a competent and experienced workers’ compensation lawyer as soon as possible. At the Law Offices of James E. Latimer, we have been successfully fighting for injured workers for years. We will start the investigation process immediately and ensure that you receive the best representation possible.