If you’re injured on the job, workers’ compensation can be a crucial safety net that helps cover medical expenses, lost wages, and rehabilitation costs. But understanding how the system works can be tricky, especially if you’ve never had to file a claim before. Many workers don’t realize the full extent of their rights, which can result in delays or even denied claims.
Before you file for workers’ compensation, it’s important to know how the system operates and what to expect along the way. Here are six key things you should understand about workers’ compensation to ensure you get the benefits you deserve.
1. Workers’ Compensation Covers More Than You Think
Many people assume that workers’ compensation only applies to injuries caused by sudden workplace accidents – like slipping on a wet floor, getting hit by falling equipment, or suffering a back injury while lifting heavy objects. While these incidents certainly qualify, workers’ compensation also covers occupational illnesses and repetitive stress injuries that develop over time.
As explained by Rosenthal, Levy, Simon & Sosa, “It’s also crucial to note that your injuries or illness didn’t need to occur due to a single incident. Usually, workers whose job duties include typing or using equipment for most of the day can sustain repetitive stress injuries, like carpal tunnel syndrome, over time. Furthermore, employees who are regularly exposed to toxic fumes or hazardous substances can develop cancer or respiratory ailments years after exposure.”
If your job has led to chronic pain, nerve damage, or long-term illnesses, you may still be eligible for workers’ compensation. The key is to document your symptoms and report them as soon as you recognize a work-related health issue.
2. You Must Report Right Away
When you’re injured at work, time is not on your side. Every state has strict deadlines for reporting workplace injuries and illnesses, and missing them could mean losing your right to benefits.
In many states, you must notify your employer within a few days or weeks of the injury. Occupational illnesses, which may take years to develop, often require reporting as soon as they are diagnosed.
Failing to report your injury or illness quickly can give your employer’s insurance company an excuse to question whether your condition is work-related. The sooner you document the issue and file a claim, the better your chances of getting approved for benefits.
3. The Insurance Company May Not Have Your Best Interests in Mind
Workers’ compensation is meant to help injured employees, but at the end of the day, insurance companies are businesses looking to protect their bottom line. This means they may try to deny or minimize your claim, arguing that:
- Your injury didn’t happen at work
- You had a pre-existing condition
- You’re exaggerating your symptoms
- You didn’t follow the proper reporting procedures
If your claim is denied, don’t assume that’s the end of the road. Many employees successfully appeal denied claims with the help of an attorney. If you suspect that your employer’s insurance provider is unfairly delaying or rejecting your claim, it’s worth speaking to a legal expert specializing in workers’ compensation cases.
4. You May Need to See an Approved Doctor
In most states, you can’t just see your regular doctor for a work-related injury and expect workers’ compensation to cover the costs. Many employers require injured workers to visit a pre-approved network of doctors or a physician chosen by their insurance company.
The problem? These doctors may be more concerned with saving the insurance company money than with providing you proper treatment. They might downplay your injuries or rush you back to work before you’re ready. If you’re uncomfortable with the doctor’s assessment, you may be entitled to a second opinion.
5. Retaliation Still Happens
Legally, your employer cannot fire you, demote you, or retaliate against you for filing a workers’ compensation claim. If they do, they’re violating the law and could face serious legal consequences.
However, that doesn’t mean some employers won’t try to get around the rules by finding other ways to make life difficult for you. Common tactics include:
- Cutting your hours or giving you undesirable shifts
- Creating a hostile work environment to pressure you into quitting
- Finding a pretext to fire you, such as poor performance reviews after your claim
If you suspect you’re being punished for filing a claim, document everything and consider speaking with a workers’ compensation attorney. Retaliation is illegal, and you have rights.
6. Hiring a Workers’ Compensation Attorney is Helpful
While you’re not legally required to have an attorney, having one can make a big difference – especially if your claim is denied or undervalued. Insurance companies and employers know how to exploit loopholes and delay payments, but an experienced lawyer knows how to fight back.
A workers’ compensation attorney will handle every step of the process, leveraging their years of experience and connections to make sure your compensation is maximized. They’ll also help you stay protected from retaliation and other negative consequences.
Putting it All Together
Workers’ compensation can be a lifeline after a workplace injury or illness, but navigating the system isn’t always easy. By working with an attorney and getting familiar with the laws in your state, you can make more educated decisions on how to proceed.
