If you suffered an injury on the job, do you need to foot the bill for your medical care or does your employer? Well, that depends.
Workers’ compensation coverage is a type of insurance that your employer purchases to cover job-related injuries among employees. It’s supposed to operate as an easy, no-fault system, but it doesn’t always work that way. Understanding why claims get denied and what to expect if your claim is approved can help you plan ahead.
Why could your workers’ comp claim be denied?
There are various reasons why your employer or their insurer may be disinclined to pay your claim. For example, your claim can be denied if your employer believes that your injury occurred during your commute to your job or if it’s self-inflicted. Denials may also happen if the insurer suspects you were under the influence of drugs or alcohol, fighting or engaging in horseplay or committing a crime when the injury occurred.
What benefits are you due if your claim is approved?
If your claim is accepted, you may be offered one or more benefits (depending on the nature of your injuries and the length of time you need to recover (if you can):
- Medical treatment for whatever problems you have related to a work-related illness or injury
- Temporary cash benefits that are designed to act as a partial wage replacement
- Long-term benefits for conditions that are ongoing or a lump sum payment to compensate you for permanent injuries
You may also be offered occupational services that can help you move into another career or light-duty work at your old job. Each case is unique, and you have to be careful that you don’t sign away any of your rights prematurely in exchange for benefits that are less than you are really due.
What can expect in your workers’ comp case?
Workers’ compensation carriers operate just like any other insurance company. Their primary goal is to keep as much money in their pockets as possible. Sometimes they quickly deny claims for trivial reasons. A lawyer can advocate for you to make sure that your rights are protected. If your workers’ comp claim is denied, it’s important to fight back.