7 Fatal Mistakes Injured Employees Make In A Workers’ Compensation Claim

  1. Not Reporting Your Injury Immediately
    In South Carolina, there is a 90 Day Notice requirement. This requirement essentially means that your employer needs to be properly notified of your work injury within 90 days. Often times an injured worker may not know the extent of his or her injury and does not report it to their supervisor. No matter how big or small your injury is, our workers’ compensation lawyer recommends reporting it to your supervisor as soon as it is possible. Sometimes, there is a tendency to not want to involve workers’ compensation out of fear that your employer may retaliate or hold the injury against you in later evaluations and reviews. Obviously, it would be wrong for an employer to retaliate against you. If, however, they are not made aware of your injury when it happens and are told about it later, they will often think you are lying and just trying to get something for nothing. Reporting a claim does not mean you have to seek medical treatment immediately. Not reporting a claim will make it difficult to get the treatment you need in a timely fashion as an investigation would be required and a First Report of Injury completed. By reporting your injury as soon as is practical, the claim will get started out on the right path.
  2. Going To Your Own Medical Provider Without Authorization
    Workers’ Compensation is coverage provided by your employer. It is designed to protect both you and your employer. It protects you by offering a way to pay for medical treatment when you get hurt on the job. However, it is also designed to insulate your employer from legal liability for their negligence or the negligence of co-workers. Because Workers’ Compensation is provided at no cost to you, the employer has the right to choose your medical providers. Of course this can easily be a source of frustration and concern for the injured worker like yourself because the doctor that your employer sends you too is most likely not one that you would choose. Going to the doctor on your own can cause problems with your case and often result in a denial of permanent or tempory benefits. The insurance company that insures your employer has no duty to pay that bill and will most likely not do so. When you have been injured on the job and have reported that injury to your supervisor and you need medical attention, request that your employer send you to a facility authorized by its insurance company.
  3. Filing The Claim On Your Health Insurance
    Many times an injured worker tries to handle injuries on their own and not get the employer involved or the injury may require emergency medical treatment. When this happens you may be asked for your insurance information. When completing an intake form or replying to an Accident Questionaire, you may be tempted to not mention the work injury in hopes that your health insurance will pay the claim. Unfortunately, too often have I seen an injury thought to be minor turn out to be quite substantial and the employee has to go back and get Workers’ Compensation involved. Filing the claim on your health insurance can kill your claim because it makes you appear to be dishonest. Credibility is important in your workers’ compensation claim. Even though you believe you are doing the right thing by not getting workers’ compensation involved, you are not being honest and in fact having your insurance pay for something that it should not have to pay. Filing on your health insurance expenses owed by workers’ compensation usually results in a denial.
  4. Failing To Tell the Doctor How You Were Injured
    Doctors rely on their patients for important information. This information helps with a proper diagnosis and treatment plan. The information you give your doctor will go in his notes. Many times an injured worker fails to accurately describe the accident or fails to mention all of the injured body parts. If the notes do not describe the accident and all of the injuries consistent with what was reported to the employer or to other doctors, the insurance companies will seize on that and make you appear to be a liar. Telling the truth, especially to your doctor is key. Liars have bad memories and if there are several different versions of what happened and what was injured, there is a good chance that the case will be denied because of a lack of credibility.
  5. Not Keeping Your Employer Informed Of Your Treatment And Work Status
    I often get asked the question whether an injured worker should talk to his employer or to his boss. The answer is yes. Keeping your supervisor informed about your treatment and your return to work schedule is critical. When you go dark and not let your supervisor know what the doctor is telling you and what the plans for your treatment are an employer will often times become angry with you. Remember, the employer still has work that needs to be done and you may not be able to return to work. The job that you were doing still needs to be done. Keeping your employer properly informed helps the employer to plan accordingly and make arrangements until your return. Not discussing your treatment and work status with your employer can lead to mistrust and doubt as to your sincerity and willingness to work.
  6. Getting Frustrated And Quitting or Resigning From Your Job
    Following a work related injury, the last thing you want to do is to quit or walk out on your employer. If you quit and the doctor writes you out of work you may not be entitled to one of the most important benefits available to you under workers’ compensation laws – weekly checks. One of the benefits of workers’ compensation is that it pays you two thirds of your weekly pay if you are written out of work by the authorized treating physician due to injuries suffered on the job. These benefits are important because they help you keep the lights on and groceries on the table while you are recovering from your injuries. At some point during your Workers’ Compensation Claim you may be returned to work on either restricted duty or light duty. The doctor wants to see if you can begin the transition back to work. It may be difficult and the restrictions may be challenged by your employer. However, getting angry and walking out on the job is not the solution. If you quit, you will not be entitled to weekly benefits. However, if the employer cannot accommodate your restrictions and is unable to provide suitable employment, you may still be eligible to receive weekly benefits if you have not quit.
  7. Trying To Handle Your Workers’ Compensation Claim On Your Own
    As with anything in life you do not know what you do not know. In a Workers’ Compensation Claim, there are many laws and regulations that govern benefits, treatment and eligibility. Employers are most often insured by an Insurance Company that writes many policies and covers numerous employers. These insurance companies have well trained Adjusters, Case Workers, Nurse Case Managers and Attorneys all working to save the insurance company money. Unfortunately, this is done at your expense. Common strategies to avoid or minimize a claim is to not authorize treatment, refuse to initiate weekly benefits, interfere with the doctor’s opinion, returning injured employee to work prematurely and denying compensable cases. Handling a complicated claim on your own can be disastrous.

Calling Schiller & Hamilton to discuss your case costs you nothing. Putting our experience to work for you will help you avoid some of the common mistakes that are often fatal in a Workers’ Compensation Claim.

Download The PDF Of Our Checklist Of Mistakes To Avoid In A Workers' Compensation Case