Under California law, most employers are required to carry workers’ compensation policies that cover employees who are injured on the job. Workers’ compensation laws are meant to protect injured employees by making sure that they are compensated for things like medical bills and lost wages when their injuries cause them to miss work.
Unfortunately, insurance companies can be very difficult to work with when it comes to workplace injury claims, and when employees do not have legal representation, insurance companies often put pressure on injured employees to settle their claims quickly and for an amount that does not fairly compensate them for their injuries.
Workers’ Compensation Benefits And Insurance Companies
Depending on injuries and damages, workers’ compensation benefits may include compensation for medical care, disability, death, and supplemental job displacement benefits. The amount of your compensation depends largely on the extent of your injuries, whether your disability is temporary or permanent, and how your ability to work is impacted by your injuries.
When employee injuries result in permanent impairment, treating doctors will assign a permanent disability rating to their injuries. Employees with higher disability ratings are entitled to greater compensation.
As mentioned above, insurance companies can be very difficult when it comes to injured employees securing the benefits that they deserve. Insurance companies want to settle their claims quickly and for the lowest amount possible, even if it means that injured employees are not fairly compensated.
When injured employees do not agree to their settlement terms, insurance companies can make the benefits recovery process incredibly burdensome.
Deny Workers’ Compensation Claims
Insurance companies sometimes deny workers’ compensation claims and unfortunately, those claims are often legitimate claims that should not be denied. Insurance companies can give many different excuses for denying your claim, including the following:
- They dispute the fact that you are injured or that you are injured to the extent that you claim.
- They claim that your injury is not related to your job and was not sustained while you were working. They also may argue that your injury is the result of a pre-existing condition or prior injury.
- They might deny your claim if you did not notify your employer of your injury or file your claim in a timely manner.
Dispute Your Medical Treatment Or Delay Approval
Under California’s workers’ compensation laws, employees are entitled to be compensated for medical treatment that is reasonable and necessary to alleviate and cure the effects of their workplace injuries. Insurance companies will often dispute that the treatment your doctor has recommended is reasonable or necessary.
Another insurance company tactic is to delay approval of your medical treatment so that your treatment cannot go forward, and you are left waiting for the insurance company to make a decision.
Request An Independent Medical Review
When an insurance company disputes the disability rating your doctor has assigned, your case will be subject to an independent medical review. This review is critical to your claim because your disability rating directly impacts the amount of permanent disability benefits that you may receive.
An independent medical review organization will review your records and then agree with the original disability rating or assign your disability a new rating.
Insurance Company Pressure
The workers’ compensation recovery process can be exhausting and overwhelming for injured employees who simply want to recover the benefits that they deserve. When insurance companies deny claims, dispute medical treatments, dispute disability ratings, and utilize other tactics to make recovery difficult, injured employees often feel significant pressure to accept unreasonably low settlement offers.
They begin to feel like recovering something is better than nothing. Unfortunately, these tactics often work with employees who do not have legal representation, and they end up settling their claims for a fraction of what they are worth.
Workers’ Compensation Attorneys
Injured employees should never feel pressured to accept settlements that do not fairly compensate them and a certified specialist attorney in workers’ compensation law will stand up to insurance companies and fight for your recovery. Workers’ compensation attorneys can represent you at any point during the workers’ compensation process, but it is always better to begin the process with an attorney.
In order to prove your claims, attorneys will help you collect and organize information and evidence to strengthen your case. They will help you with claim submissions, appeals, and other important workers’ compensation filings. They will be with you at your workers’ compensation hearings and help to make sure that you are not denied the medical care that you need.
An experienced workers’ compensation attorney will not back down to unreasonable insurance company demands during settlement negotiations because they want to help you maximize your compensation.