Being injured at work can be a scary and uncertain experience. Not only do you have to deal with pain, medical appointments, and missed work, but there’s also a chance that you might not get approved for workers’ compensation.
There are only four general reasons you wouldn’t be able to get paid through workers’ compensation:
- Your employer doesn’t carry workers’ comp insurance. Not every employer is required to carry workers’ comp, but if an employer isn’t exempt, they’re breaking the law.
- You don’t file your claim on time. There is a time limit for filing a claim, and if you miss that deadline, your claim will be denied.
- You don’t have a valid claim. To qualify for workers’ compensation, your injury must be work-related. Sometimes insurance companies will deny claims and classify them as nonwork-related if they weren’t reported right away, or if it seems like the injury was caused by a pre-existing health condition. Other reasons a claim may be deemed invalid is if the injury was sustained while you were under the influence of drugs or alcohol.
- Your claim gets unfairly denied. Valid claims get unfairly denied all the time. Insurance companies are just trying to maintain their profits, and they hope most people won’t bother to appeal.
If you’ve been trying to get financial compensation through your employer’s workers’ comp policy, but you’re not getting anywhere, here’s what to do next.
1. Talk to a workers’ comp lawyer
Some personal injury lawyers specialize in winning workers’ comp claims for injured parties who have been wrongly denied compensation. If you’re not getting anywhere, schedule a free consultation with an attorney as soon as possible. It’s not easy to battle an insurance company on your own. If you have a valid claim and you’ve been unfairly denied, you might be able to file a lawsuit.
Another reason to contact an attorney is if your employer doesn’t have a workers’ comp policy. Some employers are exempt, but a large number break the law and simply choose not to buy a policy. If your employer is legally required to carry workers’ compensation insurance, but doesn’t have coverage, that’s grounds for a lawsuit.
2. File an appeal
If you haven’t already, file an appeal if your claim was denied. Don’t assume that your appeal will be denied as well. It can happen, but sometimes appeals force an insurance company to revisit a case and see it as valid. It all depends on your situation, the details about your injury, and the person reviewing your case. However, it’s always worth a shot. In fact, if you don’t file an appeal, it might look bad in court if you decide to sue later.
3. Talk to your employer
If you’re being given the runaround, talk to your employer and ask them to fill you in on what’s happening with your claim. It’s unfortunate, but sometimes employers intentionally make it hard for employees to file workers’ comp claims. They might even attempt to intercept your claim and prevent it from being processed. On the other hand, they might not be intentionally interfering with your ability to get compensated, but you won’t know until you talk to them. If you haven’t received an update or an official denial, ask your employer if they know anything.
Although it helps to open up a dialogue with your employer, don’t count on them being too helpful. Many employers dread having their employees file workers’ comp claims, even though it’s a system designed to protect them from lawsuits. The reality is, each time a claim gets filed, it usually raises the cost of their premium. Filing a claim can force your employer to spend more money every month on coverage, which can potentially make them frustrated. Hopefully, your employer cares more about you as a person than money, but that’s not always the case.
Don’t leave anything to chance – talk to an attorney right away
The longer you wait to resolve your situation, the harder it will be to get properly compensated. If you’ve been injured at work and you’re struggling to get somewhere with your workers’ compensation claim, get a consultation with a workers’ comp attorney as fast as possible.
They’ll look at your situation, determine what your best course of action is, and guide you through the process. They might help you win an appeal, or they might suggest filing a lawsuit against your employer or the insurance company.
Every situation is different, but an attorney will tell you all of your options.
