Things That Complicate Workers Comp Claims

If you are planning for a worker's compensation claim, then you should be prepared for the potential complications you may encounter along the way. Here are some of those potential complications and how they may affect your case:

Preexisting Health Conditions

Workers compensation insurance is meant to compensate you for damages arising from injuries incurred on the job. Unfortunately, it's sometimes difficult to determine between preexisting injuries from injuries sustained while on the job. For example, if you had been injured in a car crash and then sustains further injuries in a slip and fall accident at work, it may be difficult to separate the two injuries. Matters get even more complicated when the insurance company apportions most of your injuries to the initial accident but you believe you incurred them in the workplace accident.

Off-Site Injuries

As explained above, workers compensation insurance is meant for those who get injured in the line of duty. This usually means that injuries that occur in the workplace are compensated while those that occur elsewhere aren't. Unfortunately, things aren't always that black and white in the practical world. This means you may be injured away from the workplace while still involved in your normal work activities, which means you should be compensated for the injury. The difficulty is in convincing your employer or worker's compensation insurance that you were working during the injury even if you weren't at your usual desk.

Delayed Reporting Of Injuries

If you are injured on the job, you need to report the injury to your supervisor or employer and have it documented. The sooner you do this, the easier it will be to confirm your injuries and investigate the conditions that caused it. If you delay in making the report, the conditions that caused your accident soon fade from view, and you may even be suspected of faking an injury or claiming that you were injured at work when you were injured elsewhere.

Misconducts Associated With the Injury

Workers compensation insurance doesn't require you to prove that someone was at fault for you to claim its benefits. However, there are misconducts that may make it difficult for you to claim the benefits. For example, if you get drunk in the workplace and then injure yourself due to the intoxication, it will be difficult for you to get the benefits. The circumstances of the case determine whether the misconduct was severe enough to warrant your denial of the benefits. In many cases, the insurer and the injured employee will have opposing views on the misconduct, creating a stalemate.

For more information, contact a local workers compensation lawyer.


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