Employers don’t love watching their workman’s comp premiums go up. They don’t love holding a job for an injured worker. And insurance companies don’t love paying claims.
So there are dozens of little legal loopholes these entities can slip through.
You can avoid handing them the ability to slip through some of them by avoiding actions which give them an excuse. Here are some of the most common reasons workman’s comp benefits get suspended or denied. Avoid these actions to keep the flow of benefits coming.
1. Failing to report the injury to your employer.
While it seems counter intuitive, it’s important to report the injury to your employer. And you should do your best not to leave the scene of the accident until you’ve done it.
This establishes a few important facts.
- That you were on the job, and not, say, on break, when the injury occurred.
- That the employer is aware of the claim. The employer has no obligation otherwise.
- That you’re taking the process seriously.
- Tells you which doctor to go to, since in New Jersey the carrier or employer can tell you who to see.
Immediate reporting also avoids suspicion that you’re exaggerating the injury.
Obviously if you’re unconscious or being rushed to the hospital calling a supervisor and filling out a form won’t be at the top of your to do list. Just make sure to inform your employer as soon as you can, and add the written justification for the delay.
Don’t just try to work through the injury. Being stoic is one of the easiest mistakes to make, and can lead to big problems later. Keep in mind you may not even be aware how badly you’re injured yet. Make the report and seek medical attention, even if the injury seems minor.
See also: How to Handle Minor Injuries in the New Jersey Workplace.
2. Failing to file a claim in time.
If you’re medically unable to report the injury the moment you get it then you’ll need to do so within 30 days. Ideally you’ll do it in 14 days, since you aren’t entitled to any compensation until the report’s been made.
Wait longer, and you’ll have to justify the wait. Wait longer than 90 days, and your claim will probably be denied.
Keep in mind some employers will play games with you and refuse to file the claim for you. You do not have to wait for them, but this is a good sign you want to retain a lawyer instead of waiting for anything else to go wrong.
3. Failing to comply with doctor’s instructions.
Go to every appointment. Take every medication. Do every exercise. Avoid doing everything the doctor tells you to avoid doing, both on the job and off.
Keep in mind insurance companies often hire investigators to find out what you’re doing on your off time. If your doctor tells you not to lift 50 pounds on the job, then going home and lifting a huge box off your front porch could come back to bite you later.
It can even get you accused of fraud.
By the way, fraud is a two-way street. If your employers make false or misleading statements about your injuries or workman’s compensation claims they can be held accountable for fraud too.
4. Failing to attend evaluations.
Throughout the process the doctor will be evaluating your improvement and your fitness to return to work. You must attend these evaluations.
Any refusal is grounds for suspension of benefits.
5. Failing to return to work.
Returning to work while continuing to receive benefits isn’t something most people think about. But at some point the doctor will determine what you can or can’t do on the job.
And your employers can offer light duty based on this description.
But whether it’s light duty or a return to your job while you’re continuing to receive some medical care, make sure you return to work when the doctor releases you to do so. Otherwise you can lose both your job, and your benefits.
Have your workman’s comp benefits been suspended or denied?
Sometimes you can do everything right and still receive a letter telling you that your benefits have been suspended or denied. When that happens, you need solid legal representation to ensure you can pay your medical bills and replace lost wages.
Contact Talone Law today to get the representation you deserve. Workman’s comp can get complicated fast. Don’t try to go it alone.