Four Common Mistakes Made by Unrepresented Injured Workers Following a Workplace Injury
Unless the injury is life-threatening or serious, most workers injured on the job hope for the best and simply want to feel better and get back to work. Unfortunately, hoping for the best sometimes causes an injured worker to mishandle several early aspects of his or her claim.
Don't Wait to Give Notice of a Workplace InjuryIt is not uncommon that an injured worker won't give notice immediately after a workplace injury. This can be due to fear of displeasing your employer, hoping the injury will heal on its own or not having legal authorization to work in the country.
Filing a work comp claim with your employer does not mean you must hire an attorney or that the employer or their insurance company will pay you an amount of money for your injury. What filing a claim does is it protects your rights to seek benefits, be they medical, monetary compensation or otherwise, if your injury needs more attention than merely first-aid.
Under the law, the insurance company cannot deny you benefits just because you may be unable to show you have legal authorization to work within the United States. See Lab. Code sec. 1171.5 & 3351.
There are rules regarding the amount of time you have to file a claim and generally, you are expected to give notice within one-day after you know an injury or symptom is caused by, related or due to your work. Moreover, the longer you wait to give notice, the more likely it is that your employer's insurer may deny the claim on the basis that your injury may have happened elsewhere or be due to other reasons.
Injured workers should report any injury at work to a supervisor or manager immediately or as soon as possible. If reporting in person, a DWC-1 claim form should be filled out and signed by the injured worker who should retain a copy. If reporting in person is not possible, report via certified letter addressed to the employer as soon as possible following the work injury.
Don't Fail to Exercise Your Right to Chose a Physician and be Active in Your Medical TreatmentLab. Code sec. 4600, et seq. gives you the right to choose your primary treating physician after a work injury, subject to certain rules and restrictions. However, what is common following a work injury is that the employer will direct the injured worker to a doctor or clinic of their choice.
Not surprisingly, these providers tend not to give the employee the benefit of the doubt with regard to questions concerning treatment and work status. Usually, these doctors' main concern is trying to get you back to work as soon as possible, whether you feel you are ready or not.
Whether the insurance company accepts, rejects or delays your case, it is important you choose a good doctor to care for you following a work injury. You may pre-designate the doctor of your choice if it is done in writing and before you are hurt at work. However, the doctor you choose has to agree to see you for any condition caused by your employment and that's not always possible.
Most often, in practice, you will get to choose a doctor from a list of providers maintained by the insurance company. Some doctors on the list will be more sympathetic to an injured worker while others less so. The doctor you choose to treat you will have consequences for your case. As such, it is very important to choose carefully.
An unrepresented injured worker will often obtain a bad opinion by a company-chosen doctor and then consult with an attorney. These opinions cannot be undone and cannot always be mitigated by further actions or medical opinions and can negatively impact your case. An experienced workers compensation attorney may be able to assist you in locating a good doctor near you for your work injuries before any consequential medical opinions in your case are made.
Don't Fail to Return to Work If That's What the Doctor Ordered Even If You DisagreeIf the doctor treating you for work injuries opines you are "totally temporarily disabled," the insurance company may owe you benefits which are 2/3 of your average weekly wages. Similarly, if the doctor opines you can return to work but with restrictions that cannot or will not be accommodated by the employer, you may be entitled to benefits.
But what if the doctor says you can go back to work without restrictions and you don't feel capable of doing your usual and customary work duties? Or what if you disagree with the work restrictions issued by the doctor and feel they are not stringent enough to avoid further injury? What you don't want to do is fail to respect the doctor's orders - even if you disagree with them. Doing that, for example by simply not going to work, may cause you to loose out on important benefits in your case and could even get you terminated.
Instead, take these steps when you disagree with the doctor's work status orders: (1) ensure that your treating doctor is accurately summarizing your symptoms on his or her medical reports so that the work status order is a reliable indicator of your work capacity; (2) talk to your doctor about your fears and concerns and suggest possible accommodations based on your current symptoms; (3) if you begin to feel worse after attempting light duty, communicate that immediately to your employer and doctor and ask that he or she revisit his work status order; and finally (4) if all else fails, consider changing your physician if you feel your doctor is not hearing your concerns or taking them to heart.
Don't Fail to Disclose Your Full Health/Medical HistoryThe doctor treating you for work injuries may need an accurate medical history from you to determine the proper course of treatment. Not communicating your complete and accurate medical history can hurt the quality of medical care you receive and can hurt your legal case as well.
Medical records don't lie and the insurance company will usually obtain your entire medical history following a workplace accident. Therefore, it is important that the injured worker not fail to disclose any and all past health issues with the doctor treating him or her for a work injury. Doing otherwise, when and if your medical history contradicts you, may invite speculation about your credibility and may hurt the outcome or value of your workers' compensation case.