In the event of an injury sustained at work, workers’ compensation insurance can provide assistance in paying for medical expenses and replacing lost wages. In the vast majority of cases, workers’ compensation won’t pay out for a work-related injury unless it meets both of these requirements.
Two requirements must be met before an accident may be considered work-related: first, it must have occurred on the job, and second, it must be directly connected to the work. Accidents that occur to employees, for example, when they are taking a break or eating lunch, do not qualify as work-related accidents since they did not take place while the employee was performing job-related tasks.
If the injury is the consequence of cumulative action, such as carpal tunnel syndrome or a lumbar back injury, the employee may still have problems getting their claim granted, even if the first two requirements are met. This is because cumulative action injuries are more difficult to diagnose and treat. It may be more difficult to prove that these injuries were incurred as a result of an occupational accident on the job based only on a medical examination or x-rays. This is because medical examinations and x-rays are only able to detect injuries that have already occurred.
It is likely that workers who experience these kinds of cumulative injuries will wait too long to register a claim for workers’ compensation, which will increase the risk that their injuries will be regarded as “suspicious” and that their claims will be denied.
It is essential to have a solid understanding of how the workers’ compensation system works and to be aware of when it is appropriate to seek the advice of an attorney given the intricacy of workers’ compensation claims and the various elements that can affect a case.
The first and most important step is to file a claim with the insurance company as soon as you can after suffering an injury. The longer you delay in submitting your claim, the higher the likelihood that it is a fraudulent one and will be identified as such.
You should anticipate resistance from your employer over this claim. To put it another way, the number of claims that an employer must deal with directly correlates to the amount of money that must be spent.
The insurance company will make an initial assessment as to whether or not your claim will be paid, and they will do so based on certain criteria. If the carrier decides to deny your claim, you have the option of appealing the decision to either the board or the industrial commision.
You have the option of taking legal action if they also decide to reject your claim. You are not required to retain legal representation, but doing so may be in your best interest if the severity of your injury or the amount of compensation you were awarded is in question.
Your reimbursement ought to cover not just your medical expenses but also a portion of the wages that you have lost as a result of the incident. If you believe that you are not receiving appropriate compensation or that your medical coverage has been wrongfully refused, you may require the advice of an attorney.
If your employer decides to take retaliatory action against you, the last thing you should do is consult with a legal professional about pursuing a claim for workers’ compensation and an investigation into whether or not you were fired from your employment illegally.