According to the latest U.S. occupational injury statistics, over 2.4 million people were injured at work in 2019. About 880,000 of these injuries resulted in days away from the workplace.
When workers are injured, they are entitled to benefits that cover their medical care and lost wages. These benefits are typically paid through workers’ compensation (except for federal government employees, maritime and offshore workers, and railway workers, whose injuries are covered by different laws). Workers’ comp benefits are paid on a no-fault basis, meaning injured workers do not have to prove that someone else was to blame. The system should work smoothly. Claims should be paid fairly. Unfortunately, this is not how most cases go.
There are various myths and misconceptions about work injuries and workers’ compensation claims. The goal of this article is to peek behind the curtain, exposing the truth to help injured workers understand their rights and options when dealing with any type of on-the-job injury.
Myth 1: My Employer Will Always Have My Back
You’ve given a lot to your employer. Especially if you’ve been with a company for years or decades, you probably consider your co-workers and even your boss as friends. Some companies are like tight-knit families. If you’re injured, you might think that your employer will help you. You may even believe that they’ll pay your medical bills and cover your paycheck without batting an eye. For most employees, this is not how things go. And this is how we arrive at our first myth: your employer will help you.
In our experience, the majority of employers and their workers’ compensation insurance companies are more interested in turning a profit than helping people. You may have worked for a company for 20 years, but when you’re trying to collect benefits for a serious injury, they don’t help you. Some actively try to find ways to minimize claim values, pressure employees to return to work before they’re ready, or even deny valid benefits. Do not make the mistake of assuming that your employer will help.
Myth 2: My Claim Will Be Approved Automatically
Workers’ compensation is supposed to cover all work-related accidents, work injuries, and occupational illnesses. This means that your claim should be approved, right? Not necessarily. There are a few key steps you need to take to make sure your claim is filed correctly, with all the right information and documentation. You also need to report a work injury to your employer within a certain timeframe, depending on your state. A single misstep could jeopardize your claim.
Your workers’ comp claim will not be approved automatically. It must be reviewed first, and even then, it could be denied if your employer or the insurance company thinks that you faked or exaggerated your injury, that it is not work-related, that you didn’t report it in time, or that you had a pre-existing condition.
Myth 3: All Workers’ Comp Insurance Companies Pay What a Claim Is Worth
Insurance companies are for-profit businesses. They make money by collecting premiums. They spend money when they pay out claims. It would be nice to think that insurance companies handle work injury claims fairly, but this is rarely true—especially when it comes to serious injuries that require a considerable amount of medical care and cause permanent disabilities. Seriously injured workers are at risk of facing unfairly low lump sum settlement offers or weekly payments that do not cover the full extent of their losses.
The best way to ensure that the insurance company pays fairly is by involving an attorney who has experience with work injury cases in your area. Your attorney can review the settlement offer or the details of your weekly benefits to see if it covers everything it should. If you’re experiencing any delays or had your claim denied, your attorney can file an appeal on your behalf, negotiate for a better settlement, or even take your case to court. These options are available to you because insurance companies do not always pay the fair value of work injury claims.
Myth 4: If My Claim Is Denied, I Should Trust That Decision
Did you know that about two out of three workers’ comp claims that are initially denied end up being paid within a year? This statistic was uncovered by researchers who studied 273,000 workers’ comp claims from 150 companies over a 5-year period, from January 2013 through December 2017. The study found that of all initially denied claims, 67 percent ended up being paid within 12 months. We believe this shows that most initial denials are simply invalid, unfounded, or wrong.
Workers’ comp claims are most often denied for the following reasons:
- There is no medical evidence of the injury.
- The injury is not work-related.
- The injured worker had a pre-existing condition.
- The claimant does not qualify for workers’ comp benefits.
- The claimant committed fraud or misrepresentation.
- The worker was injured because of drug or alcohol use.
- The worker did not report the injury within the required timeframe.
Many of these issues can be resolved by providing additional information or supporting documentation. Instead of trusting an initial denial, check again. Talk to a lawyer who can review the denial letter and help you in appealing the decision. This does not have to be the end of the road for your claim.
Myth 5: Any Work Injury Attorney Will Do
We have already stressed the importance of involving an attorney, but can you hire just anyone? While you can, this might not have the result you’re hoping for. Hiring an attorney is an important step in showing your employer and the insurance company that you will demand the fair benefits you deserve. You also need to make sure your attorney has the experience and know-how to get a positive result. You will only benefit from having a firm in your corner that insurance companies know by name—a firm like Arnold & Itkin. Our attorneys have reputations for results in work injury cases across the U.S. When you work with our team, you’re not working with just “any attorney.” You’re working with leading trial lawyers who will fight for the outcome you rightfully deserve.
Contact Arnold & Itkin Today: (888) 493-1629
We hope this article has helped to dispel common myths about work injuries and your rights. We also hope we’ve shed some light on the underhanded tactics that some insurance companies and employers use to avoid accepting responsibility for on-the-job injuries or paying a claim. If you’re interested in finding out more about our attorneys and the ways we can help you, we welcome you to call (888) 493-1629 for a free, private consultation. We’ve recovered over $10 billion on behalf of our clients and are ready to see what we can do to assist you.