When Your Workers' Compensation Coverage Is Not Covering Your Needs

Posted on: 25 November 2020


When you get hurt at work, your employer is supposed to provide you with certain benefits by way of a workers' compensation plan. This insurance is paid for by your employer and offers both payment of medical benefits and a disability wage. In many cases, hurt workers get the coverage they need, but not always. Read on to find out what might happen when the coverage is not covering you.

Your employer is not cooperating  

To access the workers' compensation benefits you need, your employer has to do their part. They are usually responsible for filling out and submitting the claim form that gets things started with your benefits. Some employers don't understand the rules but some drag their feet for other reasons. The sooner your claim is filed, the better. If you are having problems with your employer, contact your state workers' compensation board for advice. You may also want to speak to a lawyer that practices workers' compensation law. Sometimes, all it takes is a letter from an attorney to get the claim form rolling.

Your claim has been denied

The reasons for denial vary. If the reason is minor and easily corrected, contact the insurance carrier for help in making changes to the claim form. In some cases, the insurer needs to see corroborating information to proceed with your claim. That might mean anything from providing witness statements to other evidence like medical records. If the reason is something more serious, you may need to contact a workers' comp lawyer. Those include allegations of being under the influence at the time of the accident, that the injury or illness is not related to work, and issues with pre-existing conditions.

Your claim has been accepted but the injuries could be permanent

The game changes when your injury doesn't heal in a few weeks or so. In some cases, you will be asked to undergo a special exam (the independent medical exam) to better determine the status of your injury. When a ruling of permanent disability comes down, you may find yourself dealing with a lump-sum payment offer. This is both good and bad. No one wants to be disabled but you will need financial compensation for being unable to work. To make sure that you are paid what you need and deserve, it's highly advisable to let a workers' compensation lawyer handle the settlement negotiations for you. They know how the system works and how to get you enough to cover your needs going forward. 

For more information, contact a company like Neifert Byrne & Ozga.