Filing your workers’ compensation claim the correct way can greatly increase your odds of obtaining all of the coverage that you expected.
Insurers have a strong financial and professional motivation to limit the amount of coverage paid out for a claim, possibly even denying a claim outright. Even without this motivation, they are ethically required to question claims that have incomplete and/or conflicting evidence.
Therefore, injured workers’ should have a similar motivation to document their injury thoroughly and uphold their end of the “grand bargain” with diligent reporting and treatment follow-up. If you are a victim of a work injury and are concerned about making your claim as strong as possible, be sure to take the following steps after your injury:
File a Report Immediately After Your Injury or as Soon as You Can
Traumatic injuries happen as a result of a single incident, like a finger getting caught in machinery. These injuries should be reported immediately or as soon as possible after they occur.
Workers’ compensation laws dictate that you provide notice of such injuries within a very short time period, usually 30 days or less. Failing to report your injury in the time period could cause your claim to be denied outright or severely reduced.
Since not all workplace injuries result from one-time trauma, repetitive-stress-type injuries should be investigated and reported as soon as possible. If you feel severe pain or limited mobility and think you need professional treatment to fix it, then notify your employer preferably before your first doctor visit or immediately after.
Seek Medical Treatment as Soon as You Need It
A delay in medical treatment can later be used against you as evidence that you were not injured severely. If you have a work-related injury, make an appointment with a doctor at your next available date — even if you have to miss work — or go immediately to an emergency room or an urgent care walk-in clinic.
Similarly, do not decline certain medical treatment if you feel it would benefit your condition. The decision to wear a brace instead of a plaster cast, for instance, can indicate that an injury is less severe than described. Skipping treatments or physical therapy can likewise put the severity of your injury into question.
Include Your Work-Related Injury Source in Medical Documentation
When meeting with medical professionals, describe the circumstances of your injury and how they relate to work duties in simple, clear, concise terms. This type of documentation is especially important with repetitive stress injuries since it can dictate treatment as well as your ability to claim insurance.
Document Any Witnesses
Witnesses are critical to the success of many workers’ compensation claims. Write down the names of witnesses and ask if they are willing to give written statements, if possible.
Fill Out Reports Accurately, and Be Consistent
Every detail that can be confirmed usually strengthens an injury claim, so try to include as many as possible in your work accident reports and other forms.
By the same token, do not make estimations in one report and then change your estimate in the other. Inconsistencies greatly weaken a claim, even if they are unintentional. A good best practice is to wait until you are not feeling too shaken, too medicated or too ill to complete forms accurately.
Don’t Give Insurers More Information Than They Need
To file your claim, insurers will sometimes need signed authorization for them to access your medical records related to the injury. However, they usually do not need access to your entire medical history. Similarly, they usually do not need you to make a tape-recorded statement. Doing so unnecessarily can only give them more of an opportunity to question your claim.
To prevent being put in such a compromising situation, you can consult with an experienced New Jersey workers’ compensation lawyer for advice on what information should and should not be shared as well as when discretion should be used.
You can contact Peter N. Davis & Associates today to receive a free consultation regarding your claim and to potentially receive guidance that can increase your chances of successfully obtaining compensation.
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