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When Your Workers' Comp Claim Leads To Suspicions

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If you think that workers' compensation insurance fraud is running rampant, no one can blame you for this misconception. The idea that those hurt while on the job often commit fraud has been widely circulated, but it bears no relation to actual facts. The real numbers say that about 2% of workers' comp accident claims are fraudulent. Unfortunately, you could find yourself suffering from the side effects of that misconception after you file a claim. Read on to find out what the workers' compensation insurance carrier might do to ensure your claim is aboveboard.

You Are Being Watched

If your injury is serious enough, you could be under surveillance by the carrier. High medical bills due to catastrophic injuries can prompt this action on the part of the carrier. If your injury involves a permanent injury or one that is slow to heal, you might be the object of video surveillance every time you step out in public. To invalidate a claim and cancel your benefits, the investigator will attempt to catch you performing body movements that would not be likely given your workplace injury.

For example, if you claim to have hurt your back while lifting something heavy at work, the investigator will try to record you bending, lifting, and other similar movements. Unfortunately, this sort of surveillance can result in not only the cancellation of your claim but the loss of a job. Seek help from a workers' compensation lawyer if you have been accused of faking your claim for benefits.

Denying You Your Benefits

Just like all insurance companies, workers' compensation agencies are in business to make money. They make money by charging employers premiums, and they keep that money by denying or delaying claims. What that can mean for hurt workers is problems with claim approvals. Here are a few common and annoying actions some carriers take:

  • Holding up the payment of the weekly disability wage for hurt workers.
  • Delaying claim approvals based on incorrect or missing information.
  • Denials based on allegations that the accident and resulting injury had nothing to do with your job.
  • Denials based on lack of corroboration from witnesses to the accident.
  • Promising benefits and then failing to provide them.

No matter the reason for the delay or denial, you must remember that you are entitled to be paid for your work-related illness or accident. You should not have to jump through hoops just to get what you deserve. If you encounter issues with any aspect of your claim, whether from your employer or the insurance carrier, speak to a workers' comp attorney for help getting the benefits you need.