What You Should Know If You’re Hurt On The Job
At Miller Cohen, P.L.C., we are often asked how workers’ compensation litigation can be avoided and how to present the strongest possible case to increase the likelihood of benefits being paid. If you follow the directions outlined below, you can improve your chances of securing workers’ compensation benefits without the necessity of litigation.
You Are Required To Report The Injury
The Workers’ Disability Compensation Act (WDCA) requires an employee to report a work-related injury within 90 days, or within 90 days of the date that the employee should have reasonably known about the injury. You are not required to report your injury in writing. The WDCA merely requires you to advise your employer. However, it does not count if you report your injury to a team leader or co-worker.
Before you have any surgery, be sure you know who your employer requires you to report your work-related injuries to.
Your Employer May Have Their Own Reporting Requirements
The WDCA controls the notice requirements, but they do not control the notification rule(s) established by your employer. Therefore, you should know your employer’s injury reporting time frame to help prevent an unnecessary denial of benefits.
For instance, many employers attempt to enforce reporting an injury within 24 hours or less. Failure to comply with the employer’s rule in many cases will result in your workers’ compensation claim being denied. This is particularly true when injuries occurring on a Friday are not reported until Monday.
The employer will inevitably dispute the case by arguing that you suffered a personal injury during the weekend. The employer’s defense may be quickly thrown out by a workers’ compensation magistrate, but the failure to report the injury on Friday will often result in unnecessary litigation.
If your employer refuses to pay workers’ compensation benefits and argues that your injury notification was not timely, do not simply accept that response or drop your case.
Documenting Your Medical History Is Important
Workers’ compensation cases are often lost, or disputed, due to inaccurate and/or incomplete histories given by the injured worker to their medical providers. If you believe that your injury or disability is related to your job, you must make sure that every health care provider is specifically told of the relationship between your employment and your disability or injury.
Make sure the examining health care provider writes down what you say about the injury and how it happened. They must write everything down so there is a record of what was said and when. It is not enough to just verbally tell them what happened.
If your case goes to litigation, the medical provider will be testifying months after your original examination. Unless everything is clearly documented, there is very little chance they will remember everything you told them.
You should always request that the medical provider read back the history you provided to verify the relationship to your work is documented.
You should also request a copy of the initial medical treatment record to make sure there is consistency throughout your medical treatment. In other words, consistency in the history of your injury or illness is as just as important as accuracy.
How To Fill Out Sickness And Accident Forms
When you are injured on the job, an employer will often ask you to complete sickness and accident/short-term disability forms. This will help the employer determine whether workers’ compensation benefits should be paid to you.
Inevitably, one of the questions will concern itself with the relationship between your disability or injury and your job. The question will generally read: Is your disability a result of a work-related injury?
If there is little question in your mind that there is a connection between the injury/disability and your employment, that should be clearly stated on the sickness and accident forms.
If, on the other hand, at the time the forms are completed, you are unsure whether work played a role in the injury, you should respond with “I am uncertain at this time” or “I am waiting for medical advice.”
If at the time you complete the form, the thought of a relationship between your employment and your injury has not occurred, and you answer the question “no,” that should not later discourage you from applying for workers’ compensation. While a negative answer may complicate the workers’ compensation case, it is certainly not impossible to prove a work relationship in spite of that statement.
Sometimes sickness and accident/short-term disability benefits will be denied if you indicate your disability is related to work. If your employer and/or the workers’ compensation carrier has already denied your workers’ compensation benefits, when filling out these forms, you should indicate that the relationship is disputed.
The Employer’s Answer
Even if the employer does not think that the injury deserves benefits, you should not let this impact your decision to proceed with a claim. In many situations, the employer’s analysis of the situation is incorrect.
At the end of the day, a magistrate will usually determine whether you can secure benefits after a workers’ compensation hearing, or your attorney and the employer’s insurance company will negotiate benefits.
If you follow the above recommendations, you are more apt to secure workers’ compensation benefits without litigation; and if litigation is necessary, your case will be strengthened.
Anytime an employer indicates that workers’ compensation will not be paid, the worker should contact experienced workers’ compensation counsel for an evaluation of the claim. We would be happy to answer any of your workers’ compensation questions.