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What to Do When Worker’s Comp Doesn’t Work for You

Injuries can and do happen at work, and when they do, the worker is generally entitled to worker’s compensation. The laws regarding the compensation of injured workers vary slightly by state, but ultimately they are meant to help ensure that the employee gets fair wages and benefits if they are injured on the job.

Employers are therefore mandated by law to file for insurance that will cover workers injuries. This acts as a safety net for workers, in case the unthinkable happens. However, there are situations in which a worker might be denied compensation for injuries, frequently due to late filing or a dispute of some part of their claim.

Claims are best filed days after the accident, although most states allow a time-frame of two years within which to do so. However, the earlier you can do that, preferably within thirty days, the faster your claim can be processed.

Even if you file your claim correctly and within the appropriate amount of time, your claim may be disputed if there are questions about the circumstances surrounding the incident or the chain of liability that links your injuries to your job and employer. The insurance company, itself, may even be reluctant to pay out your claim. Some of the reasons this can occur are:

  • A discrepancy between the accident report and medical records.

  • The possible detection of illicit drugs in your system at the time of the accident.

  • A lack of witnesses to the event in question.

  • The suspicions of either your employer or the insurance firm that there may be a possibility of malingering, that is: laying false claims with the intention of getting the company to pay up or pay more without an appropriate justification.

These are just a few scenarios in which a worker’s compensation claim can be denied. When this happens, what do you do?

Get in Touch With a Personal Injury Attorney

This should be your first resort. We insist on this because we know so many people would rather try to fight it themselves — this is a trap. Appealing by yourself is often a lengthy process, and you may find yourself shortchanged in the process. As the laws tend to vary from state to state, it’s important for the sake of your claim to have an adequate understanding of where your situation fits into a complicated legal system. Getting a lawyer will not only speed up your claim process, it can help you navigate the legal landscape and ensure that you are receiving the care and benefits you deserve.

For example, if you do not receive compensation as a result of your employer not having an insurance plan, you will be informed that your employer has most likely broken the law. In Florida, for example, most non-agricultural, non-construction industries are required to provide worker’s compensation in any business with four or more employees. These stipulations vary from state to state, with the exception of Texas, which refuses to place this kind of mandate on their businesses.

Your personal injury lawyer will review your case, research the relevant statutes, and advise the necessary course of action. Many attorneys, like David Heil in Orlando, will even offer free consultations to help you determine what kind of legal support your claim may need.

This is particularly important when you’re receiving medical treatment and need to settle your medical bills. With a legal advocate to help you speed up your claim process, you can focus on what’s important — getting better, and getting back to work.

That said, each state has a cap for the damages to be paid for the typical claim. If the claim goes to court, your awards may exceed this cap due to the circumstances involved. The downside, of course, is that a court case can take time and, not surprisingly, a lot of effort and understanding of legalese.

In the presence or absence of legal representation, you have a number of resources available to you, many of which can be found through the US Department of Labor website:

  • Contact your state’s workers’ compensation ombudsman.

  • Check if your state has a temporary disability insurance program.

  • See if your state has what is known as Uninsured Employers’ Funds, often reserved for people who are injured while working for uninsured employers.

These options will help you recover some, if not all, of your medical and living expenses while you recover.

Oscar King is a freelance writer and small business owner who contributes articles and insights into issues affecting businesses and their workers, as well as the relationships between employer and employee.

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