One of the primary responsibilities of employers is to provide safe working conditions that prevent accidents from happening. However, accidents do happen sometimes and when they do, worker’s compensation insurance takes care of the wages lost as well as the medical care of the employee.
This type of insurance serves two purposes:
- To ensure that workers still have an income during the period that they are unable to get to work and must rest.
- To protect the company from being sued for the accident that happened at work which caused the injury.
How does it work?
Employers pay the insurance company to take care of the coverage if a worker gets injured while at work. As soon as an accident happens, the worker is sent to the hospital or goes to one of the specialist doctors approved by the insurance company. The insurance company pays the wage loss benefits and other medical bills while the worker is out of work recuperating.
However, there have been many instances of insurance companies halting payment of bills or denying the workers' compensation claims for certain reasons. This is why people need to know how to protect themselves from insurance companies trying to get out of paying or reducing benefits.
The interests of the insurance companies
Insurance companies will not disclose the benefits that workers should receive for their injury at work. Just like any other profit-oriented company, insurance companies may try to skimp on worker's claims to maximize their profit.
The wage loss benefits may be fair but there could be other benefits such as vocational rehabilitation or attendant care that will not be offered to the injured worker.
Employers are also required to support the worker's recovery and help him or her get back to work by helping them attend vocational rehabilitation. The assistance may be in the form of tuition refund or training for another job that the injured worker can easily perform when he gets back to work.
Make sure that you inform your doctor of the difficulty that you are having at home so that he can prescribe an attendant to care for you. In some cases, you can get a family member who can log in hours and get paid for this service.
If your employer or insurance company doesn't provide you with the benefits that are due to you, seek the help of a workers' comp attorney. You aren’t likely to have a second chance at this so make sure you choose an experienced one. Explain your situation to your lawyer to discuss your options to make sure you get all the benefits that you are entitled to.
Fortunately, workers' comp attorneys commonly do not ask for payment until you are given your due compensation. Work closely with your lawyer to ensure that your case is strong in order for you to receive your compensation. Insurance companies may give you a hard time so it would be in your best interests to handle everything perfectly on your end.
Many workers are surprised at how difficult insurance companies can be when trying to file for workers compensation claims. There are many cases of people getting injured while on the job; they follow the procedures in claiming worker’s compensation but some insurance companies stop payments or deny their claims.
Nobody wants to go through the inconvenience or prolong the process of receiving worker’s compensation especially when they are injured and in pain. Workers shouldn’t have to worry about medical bills since worker’s compensation laws dictate that they receive a fair salary and that medical fees are shouldered by insurance while they cannot work. However, there are many reports of insurance companies cutting off payments and even denying workers their compensation claims.
The employers' insurance companies have their own objectives of reducing costs which is why many employ procedures to avoid or lessen their payouts for the workers compensation claims.
The following is information collected by seasoned worker’s compensation lawyers on common and disturbing practices employed by some insurance companies:
1) Insurance companies don’t pay enough
Several insurance companies pay the wrong wage loss benefits. Frequently, insurance companies make mistakes like failing to include other items in your salary and benefits so that they will pay less.
To protect yourself, learn how to calculate your own worker's compensation rate by obtaining information of your salary records. Sometimes, the insurance company or the employer will argue about the correct rate as in order to lessen their costs.
2) Your claim can be challenged
Insurance companies typically review all cases thoroughly and may question injuries or find excuses to decline the claim. A very common strategy for denying a claim involves saying that a worker has a pre-existing condition. This may be true in some cases with traumatic injuries making the condition worse.
Should you ever get injured at work, get medical treatment immediately and watch for signs of pain . Certain injuries can take a few days to weeks to fully manifest. You will want all kinds of proof surrounding your injury should you have to argue your case.
3) Insurance companies watch you
You may not know this but some insurance companies hire detectives to watch over workers who file for compensation claims. Their reason for hiring investigators is that there are employees who are malingering and to prevent fraud and abuse.
4) Your appointed doctor may not have your best interests at heart
Insurance companies require you to get an appointment with their own approved list of doctors and will not honor any other doctor who is not in their list. Some of these doctors know what they are supposed to do. Consequently, they find ways to minimize the benefits or even brazenly flat out deny the existence of the illness.
You should know that you can find your own doctor after 10 days of the first day of treatment. Inform the insurance company of the details such as the name and address of the doctor.
The information above should give you an idea of what you can possibly expect. Make sure you are ready to respond appropriately when it is your turn to claim for a workers' compensation benefit. Get a good lawyer on your side.
Shulman & Hill Workers Compensation Firm 44 Court St, suite 808 Brooklyn, NY 11201 (718) 852-4700 shulmanwc.com