The Delicate Dance With Workers Comp Insurers
Brian O Sutter
Personal Injury
When you get injured at a full-time job, with full benefits and protections for the employees like workers compensation, you’d think that it would be a straightforward affair. If you’re fulfilling your professional responsibilities, not acting in any questionable way, and a mishap—through no fault of your own—occurs, then the fair and right thing to do for your employers is to give you the workers compensation that exists for just such occasions. You did nothing wrong while doing your job, and therefore your job—as agreed—should pay for the expenses that may be required.However, there’s one thing that can often make this procedure much more complicated than it needs to be. In some cases, it can even mean your company will not give you the compensation that you are due. The worst part of this situation is that it exists in a big, legal gray area, where what happens can’t exactly be said to be illegal, and yet at the same time, it may not be the right thing to do either.
The situation is dealing with insurers, and your reactions at that time may unwittingly play a large role in whether you get workers comp or not. If you don’t get your compensation, maybe it’s time to start thinking about a workers’ compensation attorney.
Getting The Story Down
Of course, when an accident occurs and people are injured as a result, one of the first things that everyone wants to know is “What happened?” There’s nothing unusual about this, and there are several good reasons for investigating this. Trying to find out what happened can yield more information about the nature of the injuries and how to treat them. More importantly, to management, however, is that it can get to the bottom of who is at fault in an incident, and therefore, who will be expected to shoulder the financial burden of treating injuries.
Sometimes the insurance company providing workers comp will get involved, and if you are injured and involved in the incident, they may want to conduct an investigation and ask you questions. This, in and of itself may not be much of a problem. Where it starts to become more uncertain is when the insurers ask you to give an “on the record” statement of the events and your injuries. More worryingly, they may even ask for the authorization from you to go directly to your doctor and medical records so they can secure more information about you and your medical status.
Yes Vs No
This is where things become murky for you if you were injured. If you give a recorded statement, that statement is now essentially evidence that may be used against you in court, especially if a medical claim comes up that contradicts some or all of the previous statement that you gave. If you give authorization to access your medical records or speak to your doctors, this essentially gives the insurance company full, legal permission to investigate your entire medical life, regardless of whether it is actually relevant to your specific incident. So, for example if they also find in your medical records that there is some history of drug use, they can use that as a possible cause for you being negligent on the job, because your medical records are hard, factual evidence.
However, it’s important to remember that an insurer, and the investigators working for insurers, are not law enforcement, and you have no legal obligation to give them the statements they ask for, or give your permission for them to go looking through your medical records or interview your doctor. On the other hand, if you say “no” to these requests, the insurers and investigators may say that they are unable to process your application for workers’ compensation because you are obstructing their efforts to resolve the case.
Protect Yourself & Your Rights
One thing you should not do if you sense a more aggressive, investigative tone from insurers is not panic. Remember, you do not have to surrender these rights, as these are not officers of the law. Instead, what you should do is seek the services of a good workers comp lawyer who will see to it that you, your privacy and your rights are protected.
Often, when you see these more aggressive tactics from investigators, that’s already an early warning indicator for you. They suspect a workers comp claim may not be legitimate and are already working to dispute it, hoping that you will give them more ammunition to use. You should make sure that you don’t do anything to hurt your chances of getting your workers comp. Get the guidance of an experienced lawyer that is used to fighting for the rights of hardworking employees. Make sure that your legitimate claim is legitimately processed and paid out to you.