Getting a workers' compensation claim approved is not always easy. It's the insurance company's job to differentiate between legitimate claims and fraudulent claims. They're not trying to ruin your life or harm you by turning down your claim, but if you make some mistakes when filing your claim or awaiting its approval, your claim might not appear legitimate and the insurance company might be forced to deny it. If you have a legitimate claim for workers' compensation, avoiding these mistakes will help ensure the insurance company sees it that way, too.
Mistake #1: Not following up fully with your doctor's recommended medical treatments.
If your doctor tells you to visit the chiropractor once a week, you had better do so. If he or she says to come back in three days for a reevaluation, you'd better do that, too. If you fail to follow your doctor's orders, this could make it seem, to the insurance company, that perhaps you're not as injured as you're insisting. If you fail to heal well and wish to collect lost income or damages for ongoing health consequences, your claims for these damages may be denied if you have not followed your doctor's treatment orders. The insurance company may feel that, if you were to have followed the doctor's orders, you'd be healed—and thus your ongoing medical complications are your own fault.
Mistake #2: Not being consistent with your statements.
Be very careful how you tell the story of how you became injured. Make sure you tell the exact same version of the story to everyone—your boss, the doctor, the workers' comp insurance agent, your lawyer, and so forth. When telling a dramatic story, it's easy to get pulled into exaggerating. This is not the time to try and impress anyone with a story of heroism or a dramatic injury. It's far too easy to get caught up in what starts as a slight exaggeration or lie. If the insurance company comes across one inaccuracy in your story, that may cast doubt on the authenticity of the other details of your story—and lead to your claim being denied.
Mistake #3: Posting on social media.
From the day you are injured onward, try to lay as low as possible on social media. Many insurance companies visit claimants' social media pages in order to verify the legitimacy of their claims. Something that seems innocent, like a picture of you holding your child on your hip at a birthday party, might be taken by the workers' comp insurance company as evidence that you're not as injured as you claim to be. Specifically, you should avoid posting pictures, logs of any exercises you perform or gym pictures, mentions of purchases you've made, and commentary about your injury or case. If you can possible bear it, it's probably easiest to just avoid social media entirely, since you can never be sure how something that seems innocent to you might be perceived by the insurance company. Set your accounts to private and disable the functions that allow friends to tag you in posts and photos.
Mistake #4: Not seeking out legal guidance from the get-go.
Many injured workers make the mistake of trying to file the claim themselves without the guidance of a lawyer, only to have it denied. Then, they end up having to hire a lawyer when they refile their claim. You'll save a lot of time and money by hiring a lawyer to guide you through the claim filing process from the get-go. Your lawyer will make sure all paperwork is filled out properly and that your story is presented in the best possible light so you stand a better chance of having your claim approved the first time.
If you've been injured on the job, your first steps should be to seek medical attention, tell your boss, and seek representation by a knowledgeable workers' compensation attorney.
