Tips for Making Sure Your Workers’ Compensation Claim is Paid

If you are injured on the job and unable to work, you are entitled to receive workers’ compensation for your medical treatment and income benefits. But just because you are entitled to this state-based program does not mean that you will receive your full workers’ compensation benefits. Work injury claims are handled by insurance companies, which are for-profit businesses. These companies are always looking for ways to avoid paying the claims. However, there are some ways to help ensure your workers’ compensation claim is paid in full.

Report Your Injury As Soon As Possible

If you are hurt at work, report your injuries immediately to your boss or supervisor. Under Georgia’s workers’ compensation laws, you officially have 30 days to report any work-related injuries. But workers’ compensation insurers will likely deny a claim if the employee did not report his or her injury immediately. The longer an employee waits to report their injury, the more difficult it becomes to convince the workers’ compensation insurer that you have a legitimate claim.

Seek Medical Treatment

If you are injured at work, make sure you seek medical treatment as soon as possible. If it is an emergency, go to the emergency room or an urgent care clinic. If your injury is a non-emergency, ask your employer for the list of workers’ compensation doctors. Do not wait. Prompt medical care can mean a faster recovery and an opportunity to document your injuries. If you wait too long or wait a few days to see whether you feel better, the workers’ compensation insurer will assume that your injury isn’t that bad or that it didn’t happen at all.

Based on your employer and workers’ compensation program, you might be required to see a doctor selected by the insurance company. This can lead to a potential conflict. Doctors who are paid by the insurance companies may not always have your best interests in mind. They might minimize your diagnosis or treatment so the insurer doesn’t have to pay the claim. Or, the doctor may deny an expensive but needed test in order to save the insurer money. If you feel like your doctor is not making your health a priority, it’s time to switch to a different physician. You are allowed one change of physician under Georgia workers’ compensation law.

While you are being treated for your injuries, make sure you go to all medical appointments. If you miss your doctor’s visits, the insurer will try to claim that you are healed or that your injury is not that serious – and will attempt to deny or terminate your workers’ compensation benefits.

Keep Detailed Records

A successful workers’ compensation claim can depend on the amount of details in your records. Be sure to keep accurate notes on, or photocopies of, the following:

• Accident report
• Witness names and contact information
• Out-of-pocket expenses such as bandages, over-the-counter medications, gas receipts, parking fees
• Mileage, including the dates and destination
• Appointments with doctors, specialists, physical therapists
• Work restriction paperwork
• Phone calls with insurance company
• Messages from insurance company
• Letters from insurance company
• Messages left with insurance company
• Letters from employer

Workers’ compensation insurers will also attempt to deny or limit your claim if your medical records do not describe the accident, injuries, and treatment in detail. To ensure that your health care providers include all of this information in your medical records, you should clearly describe where and how the work accident happened.

Be Specific and Consistent in Your Statements

When you are talking to your health provider or the workers’ compensation insurer, make sure your statements about the accident and your injuries are specific, clear, and consistent. Insurance companies have document experts who carefully examine every report and record. The company will try to deny or limit the claim if the statements to your doctor and insurer vary in any way. Some insurers will ask to record your statement about the accident and injuries. This is not a good idea, and it will not likely help your claim. If an insurance representative calls you and asks to record the conversation, you have the right to say “no.”

Georgia Workers’ Compensation Attorney

If you’ve been injured on the job, you need an Atlanta workers’ compensation attorney. The Law Offices of Laura Lanzisera can explain Georgia’s workers’ compensation system and the benefits available for your disability. We can help value your claim and negotiate with the insurance company. Contact our office today for a free consultation.