If you are the victim of a workplace injury and have followed all of the proper steps to report and treat your injury, you should be eligible for workers’ comp benefits. Working with an attorney can ensure that you understand your rights and that you are given the full compensation you deserve. When working with an attorney, they will advise you on what to do and what not to do when it comes to your injury and your claim. Among their advice, they may discuss with you some of the methods the insurance company can and will use to stop or cut off your workers’ compensation benefits. .
The following are 5 methods an employer’s insurance carrier can use to attempt to stop or cut off your benefits:
1. Surveillance or Private Investigation
One standard practice of employers’ workers’ compensation insurance companies is to hire a private investigator to “check up on you” to ensure you are as injured as you claim. The purpose of this is to catch incidences of fraud, where people claim to be injured as a way to get workers’ comp benefits from their job without working. If a private investigator sees you doing something that you should not be able to do with your injury (for example, lifting something heavy if you have restrictions or operating a vehicle if your doctor claims you cannot drive), then they will report it to the insurance carrier who can use the evidence to deny your benefits.
2. Failure to Follow Treatment Plan or Gaps in Medical Treatment
When you are out on workers’ compensation, it’s important that you are not only seen by a medical professional, but that you follow the treatment plan set for you by that professional. This may include seeing specialists, getting tests done or going to regular physical therapy appointments. It’s OK if you have to reschedule or miss one appointment, but regular gaps in treatment puts up a red flag for insurance carriers. They will use that information to claim you are not as hurt as you say you are, and therefore attempt to deny or stop your workers’ comp benefits.
3. Refusal of Light Duty/Limited Duty
In some cases, when you are unable to perform your standard duties because of workplace injury, your employer and your treating physician may determine that you can return on a limited basis or with a new set of responsibilities. This may be referred to as “light duty” or “limited” duty. For example, someone who used to drive a delivery truck may now be taking inventory in a warehouse, or someone who used to work on a production line may now be filing paperwork. If you are able to reasonably complete limited or light duty work, but refuse to do so, the insurance carrier can use this against you. If you are concerned with your ability to complete the light duty tasks, you should always speak with your attorney before saying anything to your employer so that you don’t risk losing your benefits.
If you have a pending workers’ compensation claim or if you have a claim that is been denied, do not quit your job without consulting an attorney first. In Pennsylvania voluntarily quitting your job could result in a forfeiture of wage loss benefits. Workers’ compensation claims can be incredibly frustrating especially if you are dealing with a less than reputable Employer. However, regardless of how difficult your situation may be, consult an attorney before you decide to quit.
5. Independent Medical Examination
If you are scheduled by the insurance carrier for an IME (independent medical examination) contact an attorney as soon as possible. The IME “doctor” is not your friend or your treating physician. The IME doctor will not offer treatment advice. The IME is a “doctor” hired by the insurance carrier to “assess the status of your claim.” It is imperative that you speak with an attorney when the exam is scheduled to determine whether or not you must go or at the very least to prepare you for what to expect. Seeking the advice of counsel after the examination takes place may put your future attorney at a significant disadvantage.
What to do if you are being denied Workers’ Comp Benefits
If you are being denied Workers’ Compensation Benefits, you should contact an attorney to discuss your options. Georgelis, Larsen & Sabatino Injury Law Firm, P.C. has experienced workers’ compensation specialists who earn large settlements for their clients and will guide you through the process. For a free consultation, call 1-800-HURT-NOW.