Adverse Rulings On Your Workers’ Compensation Claim: How To Cope

If it's not bad enough to be hurt from a work injury, you may also find an adverse action letter in your mailbox one day. The workers' comp insurer for your employer can find a variety of minor issues with your claim and any one of them will put a stop to your ability to obtain benefits. The adverse rulings below can all be rectified if you know what to do.

The claim form failed to list witnesses or corroborating evidence

In many cases, your injury had no witnesses. In some cases, co-workers and others are too intimidated by their employer to come forward and give a statement. Speak to your co-workers, and see if your employer recorded the accident. Things may only happen after you take legal action by speaking to a workers' comp lawyer.

The employer is claiming that the accident did not occur at work

Workers don't necessarily have to be at the work location to be eligible for workers' comp benefits. However, some employers are not well-educated on the complexities of workers' comp law. You are covered while away from your work location if you are performing work for your employer. That includes business travel, the company softball game and picnic, fetching lunch for a supervisor, going to an off-site training session, and more. If your employer fails to file a claim form, speak to your state's workers' compensation board and then a workers' comp lawyer.

The workers' comp insurer has denied your claim based on preexisting conditions

Workers are covered for any condition made worse by the job. For example, if a worker is being treated for hypertension (high blood pressure) and has a stroke as a result of stressful work conditions, they may be entitled to workers' compensation benefits. A workers' comp lawyer can help you obtain the medical proof you need to have your claim reinstated.

You need more time to recuperate, but the insurer is insisting you return to work

Frequently, there are disagreements between the employee, the workers' comp insurer, and medical practitioners about when someone can return to work. Know that workers have rights and an appeals process when they are asked to return to work too soon after an injury. In many cases, the insurer may ask the worker to undergo a special medical examination when issues arise. If you disagree with the results of that exam, you have the right to another exam performed by a different doctor.