In order to maximize the effectiveness of your workers’ compensation claim, there are certain steps you’ll need to take. Read on to learn what you need to do in order to get the most out of your claim.
10 Things To Do For Your Claim
#1 - Seek medical care immediately.
The longer you wait to seek medical care after a work injury, the more your chances of having a viable claim are reduced. If you’re hurt at work, it’s in your best interest to obtain medical care right away rather than waiting a few days to see if your injury heals on its own.
If your superior wants to call for an ambulance or to take you to the company nurse, allow it.
The insurance company has grounds to deny your claim if you wait too long to obtain medical care. They may argue that your injury did not happen while you were working, or that your injuries can’t be too severe if you waited to seek care.
#2 - Alert your employer of the injury.
There’s no viable reason to wait to tell your employer that you were injured while working. The more time that passes before you tell them, the more difficult it will be for your employer or the workers’ compensation insurance company to trust that you have a legitimate workers’ compensation claim.
Your employer likely has a standard Report of Injury form for you to fill out and return to them.
It’s crucial that you report the injury to your employer, even if you’re concerned that you’ll get in trouble or fired. Keep in mind that it’s unlawful for your employer to harass or fire you for reporting a work-related injury or for filing a workers’ compensation claim. If this happens to you, contact a personal injury attorney right away.
#3 - Be speedy about filing your workers’ compensation claim.
Simply telling your employer that you were hurt is not equivalent to filing a workers’ compensation claim. You’ll need to do both in order to be eligible for benefits.
Once you’ve made your employer aware of your work-related injury, you’ll be provided with a workers’ compensation claim form. Be sure you accurately complete the form in its entirety. Keep in mind that an unfinished or sloppy form can slow down the compensation process.
According to the Mississippi Workers’ Compensation Commission, you must file a claim with the Commission within two years of the date of the injury. If you fail to do so before the two-year period ends, you forfeit your right to any and all benefits.
#4 - Choose or change your physician.
You’ll need to choose a physician who is authorized by your employer’s insurance company. Keep in mind that you are not stuck with the physician you choose first. If you are dissatisfied with the care and treatment you receive, you have the option to switch doctors. You’ll just need to notify the workers’ compensation insurance adjuster prior to beginning care with a new doctor.
It’s wise to consider that insurance company doctors can have a conflict of interest. Said simply, the physician’s desire to continue receiving regular compensation from the insurance company may affect the way your injury is diagnosed and treated. For instance, the physician may reject a costly test, such as an MRI, or clear you to return to work before you’ve completely healed.
Your number one priority in selecting a doctor should be to find a physician who will provide a sincere evaluation and disability rating for your injury, even if it means the insurance company will have to pay more money.
#5 - Be precise and consistent with your statement.
You’ll likely come in contact with several people who will need to know how you were injured. Be sure that you tell every medical provider you speak with precisely how your work-related injury occurred.
Be sincere, precise, and don’t make excuses for your injuries or symptoms. Everything you say will be analyzed by experts employed by the insurance company who will carefully review every report and medical record in an attempt to find a reason to deny your claim or limit your benefits.
The insurance company will also seek out any pre-existing conditions you have that can provide an excuse for them to deny your claim. In light of this, it’s important that you don’t attempt to hide any previous injuries or conditions, but make it very clear that you had no disabling symptoms prior to the work accident that prompted your current injury.
It’s best to be specific rather than providing loose descriptions about your injury. Rather than saying this:
“I was sweeping the sales floor and now my back hurts really bad.”
Say something more like this:
“I clocked in at 10:00 and shortly after, I was sweeping the floor because a customer dropped a container filled with loose powder. While sweeping, I felt something pop in the middle of my back. I felt severe pain right away and I was unable to straighten my back. I was in so much pain that I felt sick to my stomach. I’ve never felt pain like this before, and it hasn’t subsided since that morning.”
#6 - Be mindful when providing medical authorizations.
Don’t ever give the insurance company a general release to obtain your medical records. This is information they don’t need to know and are not entitled to.
Take caution when signing authorizations from people hired by the insurance company. They may be sneaky and try to get you to sign one provided by a vocational counselor or the workers’ compensation doctor.
If you sign any authorizations, make sure that they specifically say it is just for your on-the-job injury-related records dated after the date of the accident.
Don’t put yourself in a vulnerable position by giving the insurance company permission to obtain your medical records. The insurance adjuster isn’t allowed to tell you that you have to sign their version of a medical authorization or you forfeit your benefits. You have the right to make changes in ink to the version they provide, you can type up your own, or consult a skilled workers’ compensation attorney to fight for you.
#7 - Keep in mind that your words and actions are being tracked.
The insurance company will stop at nothing to discredit your claim. If you are injured, it’s best not to push it by engaging in activities that can harm your claim.
Given the technology that’s available today, it’s relatively easy to catch people doing what they’re not supposed to be doing. If you’re seriously injured, you probably can’t handle everyday tasks such as:
- Unloading heavy bags of groceries from your car
- Easily walk to the mailbox with no difficulties
- Pick up your crying toddler
Even if you think no one is watching, you still shouldn’t do any of the above actions until you’ve been cleared by your doctor. The insurance company may not only be watching you, they may also be recording video of you.
Even if no one records video of you, the insurance company is keeping an eye on you in other ways, like:
- Social media: Comments that you post or are posted about you and images of you are admissible; including posts that other people make.
- Medical documents: The insurance company will exhaustively investigate your medical and therapy records. It will be noted in your records when you do any of the following:
- Fail to follow directions
- Fail to properly take medications
- Skip therapy sessions
- Appointments: If you miss an appointment to any of the following, your benefits may be terminated:
- Vocational counselor
- Insurance company doctor
- Fail to appear at a workers’ compensation hearing
#8 - Prepare yourself for an Independent Medical Examination.
You may be asked by the insurance company to endure an Independent Medical Examination (IME). The IME will be directed by one of the insurance company’s doctors and can happen at any time.
Keep in mind that the IME doctor is working to help the insurance company, not you. You will not receive any medical treatment or advice from an IME physician. The only reason for this exam is to provide the insurance company with “expert” opinions regarding your ability to return to work and stop receiving benefits.
Your benefits may be terminated immediately if you refuse to go to an IME. Keep in mind that the insurance company cannot require unlimited IMEs, but it only takes one bad one for you to have your benefits revoked or reduced.
#9 - Be very careful when providing a recorded statement.
Providing a statement regarding what happened when the accident occurred can be tricky. You’ll likely have to provide a recorded statement to the insurance company, but it’s important that you do so only when you’re ready.
If the insurance company contacts you asking for a statement before you’re ready, tell them that they do not have your permission to record your statement at this time.
It’s in your best interest to provide your recorded statement with your attorney present. Regardless of how or when you provide your statement, it’s important to do so when you are in a good mood and not tired, upset, in pain, or taking medications.
#10 - Know what your disability rating means and retain all relevant documentation.
The definitions of the workers’ compensation disability categories are as follows:
- Temporary Total Disability
- Fully prevents you from working for a limited period of time.
- Temporary Partial Disability
- Prevents you from doing some, but not all, of your job-related tasks for a limited period of time.
- Permanent Total Disability
- Prevents you from ever returning to work, whether for your current employer or another employer.
- Permanent Partial Disability
- A lifelong injury that somewhat impairs your ability to work.
If your disability is determined to be permanent, a score will be added by your doctor to show how severe your disability is. These scores may range from 5-100%.
If you disagree with the rating provided, you have the option to obtain a second opinion from a qualified physician, but you might need to pay out-of-pocket for the exam.
Speaking of out-of-pocket expenses, it’s in your best interest to retain all documentation you receive that pertains to your work-related injury. You’ll have the best chances of success with good recordkeeping. Make copies of everything, including all the forms you’ve completed. It may also be helpful to keep a digital record of everything, just in case.
Make sure all of your paperwork is neat and well organized. Take detailed notes of every contact you have with anyone regarding your claim.
Most of your out-of-pocket expenses will be reimbursable. Retain receipts for parking lot fees, bandages, over the counter drugs, and the gas you put in your car to take you to your appointments.
Log your vehicle’s mileage and the gas you buy so you can get to the various medical facilities, pharmacies, and other places you need to go to so that you receive the care you need. Be sure to include the dates, destinations, and mileage for all the places you go to treat your injury.
If you need to meet with a vocational counselor consistently, you may track that mileage as well.
It’s a good idea to regularly send a letter to the insurance company requesting reimbursement for your out-of-pocket expenses. Be sure to include copies of your receipts, mileage, and gasoline logs.
We’re Here for Your Support
If you’ve been injured in a work-related accident, we may be able to help you obtain the compensation you deserve. Whether you need help from the very beginning of the process, or if your claim has been denied, we have the knowledge and resources you need to have the best chances of a successful outcome. Don’t hesitate to contact our office right away with any questions you may have.
Call our attorneys at ‘Maggio | Thompson, LLP at (601) 265-6869 or contact us online to schedule a free, confidential consultation.