Common Mistakes in Workers' Compensation Claims and How to Avoid Them

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Has filing a workers' compensation claim ever left you totally confused?

You're not alone. Sustaining an injury on the job is bad enough. Filing a workers' comp claim is often a headache on top of the problem.

Here's the deal...

20% of workers' comp claims are denied nationwide.

That means that 1 in 5 injured workers aren't getting the benefits that they should. And the worst part? Most of these denials are because of avoidable mistakes.

The good news is that you can greatly increase your chances of approval if you avoid these common pitfalls. In more complex cases or a denial, it can also help to enlist the assistance of a workers comp attorney out of Fresno.

Let's dive into some of the mistakes that could cost you your workers' comp claim...

In This Article We Cover:

Biggest Filing Mistakes Workers Make

Do you know the most common mistake that ends workers' comp claims?

It's waiting too long to report the injury.

Most states only allow you 30 days to notify your employer of an injury suffered on the job. Miss that window and your claim may get denied before it even starts. Doesn't matter how serious the injury is, or how obviously it was caused by your job.

The problem is many workers assume they can "tough it out", or that their injury isn't serious enough to report. They wait and see if it goes away. By the time they realize they need medical treatment, it's too late.

The moral of the story is to report any injuries immediately. Even if you think it's minor. Even if you don't want to file a claim. At least get it documented that you were injured. You can always change your mind later and decline to file a claim. You can't go back in time and report an injury you didn't report.

Documentation Errors That Kill Claims

This is a biggie...

Incomplete or incorrect paperwork will sink your claim faster than anything else.

Workers' comp forms are not user friendly. A missing signature, a blank line, or a section filled out incorrectly can delay your claim for weeks, if not outright deny it.

Some of the most common paperwork mistakes include:

And don't forget...

Your initial injury report becomes the baseline for your entire claim. Insurance companies will use what you said in that report to judge everything you say later on. So any inconsistencies or changes can be used against you to deny your claim or reduce your benefits.

Take your time. Be thorough. Answer every question in full. If you don't know the answer to something, ask for help instead of making a guess.

Medical Treatment Missteps

Did you know one of the fastest ways to lose your claim is to...

fail to seek immediate medical attention for your injury?

Even if it seems minor, get checked out by a doctor as soon as possible. The longer you wait, the easier it is for an insurance company to argue that your injury isn't work related or that it wasn't really that serious.

But that's not all there is to it...

You also have to follow through with recommended medical care. Missed appointments? Skipped treatment? Avoided physical therapy?

The insurance company will take that against you. Say you aren't actually injured, or that you are prolonging your recovery by not following doctor's orders.

Document all of the following:

This is all very important if your claim is ever disputed or goes to litigation. Research shows that 33% to 69% of work-related injuries may not be reported or counted. In many cases, this is because workers don't know the importance of this type of medical documentation.

Communication Failures

Know what mistake is one hundred percent avoidable?

Failure to clearly communicate with your employer and their insurance company.

Once your claim is filed, you need to maintain contact with everyone involved. Which means:

What happens when people don't communicate?

Deadlines get missed. Forms don't get submitted. Medical records sit in your doctor's office instead of being sent. Your claim gets held up indefinitely because everyone assumes it's someone else's job.

Pro Tip: Email is your friend. It's almost always better to send an email than to make a phone call. If someone tells you something important over the phone, follow up with an email to confirm it was said.

When You Actually Need Legal Help

Let me cut to the chase...

Not every workers' comp case needs a lawyer. If your injury is minor, your employer is cooperative, and your claim is approved quickly, you may not require legal assistance.

However, there are certain situations where it is prudent to hire a workers comp attorney:

The reality is that it can be very difficult for a layperson to successfully navigate a contested claim on their own. Insurance companies have legal representation. Why shouldn't you?

Having a skilled attorney can greatly improve your chances for a positive outcome. Research shows that workers with legal representation receive higher settlements and better results than those who do not.

Final Thoughts

Making mistakes on your workers' compensation claim can be very costly. Lost benefits, lost time, and a whole lot of stress. But here's the good news...

Most of these mistakes are 100% avoidable.

Report your injury ASAP. Fill out all paperwork completely and accurately. Get medical care right away, and then follow through with it. Keep records of everything. Communicate with everyone in a timely manner.

If your claim gets denied or becomes complex, don't be afraid to ask for help. The system is there to protect you as an injured worker, but only if you know how it works.

Just remember... You have rights as an injured worker. Don't let small mistakes derail your ability to receive the benefits and compensation you deserve.