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Worker’s Compensation Process and Pitfalls

When a family member is injured on the job it is a potentially disastrous situation, especially if that family member is the sole provider. The loss of a family member’s entire income can leave the family in dire financial straights. The Worker’s Compensation system, also known as Worker’s Comp., is designed to prevent these types of tragedies. The main purpose of the Worker’s Comp. system is to provide medical coverage, disability if the victim is unable to return to work, and if necessary, retraining and rehab to help the victim return to work. While this system sounds like the ideal security blanket, the system itself has many flaws and pitfalls that can make a difficult situation worse.

As personal injury lawyers serving Vermont and New Hampshire, we have seen many people struggle through the Worker’s Compensation system while seeking entitled benefits. Employees must notify their supervisor of the injuries, and the supervisor must notify the company’s Worker’s Comp. coordinator. The Worker’s Comp. coordinator must notify the company’s insurance carrier. Now, if you have read any of our other publications or articles you know how insurance companies can treat claims. Insurance companies don’t make money by paying out claims; they make money by figuring out ways not to pay claims. I have heard stories of injured workers being sent to doctors that are friendly to the insurance carrier. Those doctors will give the injured worker a clean bill of health even though the worker may still be injured. Sometimes the worker may not be able to return to work, though they want to. They want to provide for their families, but are often treated as if they are trying to defraud the company.

Anybody who has suffered work related injuries and has dealt with the Worker’s Compensation system knows how Reflex Sympathetic Dystrophy, or RSD, can make a bad situation worse. RSD is a disease that often follows an injury. After an injury, the body’s reflex nerves may be affected. As the injury heals, the pain does not subside. Instead, the pain can get worse. The nerve areas become more sensitive to physical contact. What insurance carriers will see is the injury has healed. They will argue that all pain and disability associated with the injury has been cured. However, the victim may be left with pain that is worse than the initial injury. The insurance company and the employer may make the injured worker feel like they are crazy or faking an injury just to get out of work. After all, they don’t want to pay any claims, let alone permanent disability.

If you have been injured at work, there are steps you can take to make a successful Worker’s Compensation claim. After you notify your employer of your injury, make sure they actually file the Worker’s Comp. claim and get a copy of the paperwork. Be prompt in you application for a hearing if the insurance company rejects your benefits claim. If you are terminated from your position soon after filing a claim (yes this does happen, once again insurance companies and employers will find ways to not pay claims) make sure you file a complaint with the state. If you feel you were injured because of unsafe working conditions at your job, contact the Occupational Safety and Health Administration (OSHA). Finally, it may be advisable to research and hire an experienced personal injury lawyer. The attorney can assist you with the Worker’s Comp. process and any potential third party claims you may have for your in jury.

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