Before you read this article I want you to know that I am not an attorney or any sort of legal professional. I am merely someone sharing a few things I’ve learned through personal experience as well as people I have known who were injured on the job and thus tangled in a workman’s comp web.
There seems to be a lot of injustices in the system workman’s comp uses. To be fair there is also a lot of minor injuries that some people over inflate in an effort to collect benefits well after their injuries have healed. In any event, the first thing you need to do after alerting your boss that you’ve been in a work related accident and telling him exactly what happened is to seek legal council. They can direct you what to do next. In a lot of cases some attorneys can tell you where to go to seek medical attention. Also, try to remember who may have witnessed the accident, this to is very important as some insurance companies try to discredit you in saying you were to blame. I also want to say unless you are truly injured with an injury that will impair you in some way or at least hinder your ability to work for a while, don’t bother, just lick your wounds and move on, as fraudulent claims make it increasingly difficult on the truly injured. If you are able to work, by all means do so!
One thing that’s been realized is that insurance companies and their adjusters are not your friends. Simply put, their in business to make money not to support charity cases. Unfortunately that’s how they view injured workers as a drain on their economy. This doesn’t mean they are all bad people, to them it’s all about the money and paying out as little as possible. Many of these people are just looking out for their companies best interest. Sadly paying injured workers is not in their best interest.
The sooner you understand how they think, and to them it is all about the bottom line and how they can hold on to it. The sooner you’ll understand what their so called system is doing to injured workers.
Your average weekly salary no matter what your profession is a very important factor in your claims value. It is the basis on what the adjuster will use to value your claim. What this means is all the hours you worked including overtime, bonuses for performance, holiday bonuses, per diem, including money for gas, meals, lodging, or any other allowances are all factors in determining your weekly salary. One of the most difficult things is tips. Everybody knows people who as servers and rely on tips for their wage don’t always report it all. Generally, your wage will be determined at a rate of a servers wage which in most cases is less than or around three to four dollars an hour. Fighting for unreported income is difficult but can be done. This may be the difference in just making it or being in the poor house. Reporting all your income and being able to prove it is extremely important. Because as we know workers comp only pays 66.6% of your wages which in a lot of cases is not enough to survive.
Once you start getting checks don’t think that they can’t be stopped, this is not the case. There are a few ways that they indeed can be stopped. They do have ways to stop paying you, after all this is their main objective. They can’t be stopped just for any reason like they don’t like you so they don’t want to pay you. At some point they may have someone like a private investigator follow you to see if you are doing something you previously said you were unable to. This isn’t much to worry about and in fact gives them a look at what you do in your day to day life. If your not lifting heavy objects or changing car tires or doing something you say you can’t then it’s no big deal. But if you are doing something you say your are unable to do than surely there will be trouble. Another way is often a tactic used by insurance companies, they get your employer to create a job for you until you are better and in some cases paying the same wage as before your injury. Now the wage may not be as much but this will still allow the insurance company to pay you less. In a nut shell if you can do a little work maybe not your old profession workers comp can adjust your check accordingly which is always less never more. Supposed your boss comes up with something just to keep you busy until you heal, nothing much really, busy work, something where you can be sedentary and still get paid the same as before your injury. If this sounds good you had better rethink it. The insurance company can now cut off your check, because if you go back to work the insurance gains the upper hand, and you lose any kind of leverage you may have once had. No one can force them to start paying you again. Next, it’s only a matter of time before your boss gets tired of paying you for nothing. It may not seem like nothing to you, but to them it’s not what they hired you for in the first place and they will undoubtedly let you go.
At this point you couldn’t be worse off, no employer wants to hire anyone who’s not able bodied or has a host of physical limitations with medical problems. Likewise, would they hire you knowing you are involved in a comp dispute against your last employer. Do not get me wrong, if you are capable of work, you should work, but, make sure it’s a real job and not made up for the sake of the insurance company and your employer to save a few bucks. A job that will be offered to able bodied person walking in off the street. That is only if your up for it, and you can do the work without any risk of further injuries or issues stemming from your previous accident. Give it serious thought. You will be compensated until you go back to work that is if you are ever able and if you are not able likely there will be a settlement agreed upon. What happens if you really can not do the job? Or your injuries resurface and you just went back to work rather than reaching a settlement agreement? The adjuster is supposed to send you back to a physician usually the treating doctor. What happens next is that they will take you out of work and put you back on the insurance companies payroll, now, how happy do you think they will be to send you back to the Dr knowing the ultimate outcome? Not very. In fact it probably won’t happen anytime soon and there is no way to speed them up. As long as you still collecting comp checks the ball is still in your court a leverage you hold over them. So before returning to work be sure you are able to do the job and know what job it is you are going back to do. Do this only if your Dr. agrees.
When and if the insurance company accepts your claim for some reason they get to choose your doctor. You can get a second opinion or at least ask for it, but you’ll have to pay for it. You should understand insurance companies have been around a long time even in your area. If you bear that in mind than you should also understand that there probably very familiar with most Dr’s in your area. That would probably hold true for the Dr’s specializing in injuries most workers suffer, what this means is they are all to familiar with which doctor will listen to the patient rather than the insurance company. Remember, sending you back to work quickly is in their best interest. A doctor who would listen to a patient when a patient says that they are having a lot of problems is not something an insurance company of adjuster is looking for in a doctor. To them it’s all about them hanging on to their money. You can be certain this is why they have chosen a doctor that you are going to.
This is no way that the doctors they use most frequently are not great doctors, it’s just another part of their hidden agenda, and one of the many ways they have of getting you back to work whether you are ready or not. That being said, I am sure the doctor they sent you to come highly recommended at least by their standards. The adjusters or the insurance companies certainly wouldn’t want anything bad to happen if surgery was necessary – that pay out would be tremendous and cost them even more of their precious money. They do want however
the doctor they choose to have their back and side with them should the situation arise. Basically, they look for doctors who are more apt to side with them verses the injured party.
A rehab nurse will be assigned to your case. A smiling face, someone who seems friendly enough to share your problems with. IT IS NOT WHO OR WHAT IT SEEMS! There not your friend, it’s all a big front to get you to feel relaxed enough to volunteer info that they can in some way use against you for their benefit. You are better off not to say too much. Answer any reasonable questions as there will be many. Any medical, or legal questions are best left for your doctor or attorney to field. Their sole purpose is to provide the insurance company with information although they are supposed to put your best interest first they still work for and are hired by the insurance company. Yet if they were supposed to put your interest first than why do they take anything you may say to them and twist it around and use it and try to throw you in front of a fast moving bus? I urge you not to answer any questions of a medical, legal, or of a nature where it could be misused – and misused it will be.
Remember although every case is unique they will all be met with the same tactical protocol, that is discourage, discredit, and ultimately try to deny. They treat every injury as suspect and view them as almost criminal to try to keep you from pursuing your case to the fullest. So please always be on alert and always keep everything documented with your doctor as well as your attorney because they truly don’t care about you or have your best interest at heart. To them it’s all about their bottom line!