Avoiding Common Mistakes

The most common mistakes made by workers claiming workers' compensation for an injury or illness are:

Failure to report the injury or illness.

Virtually all states require prompt reporting of accidents, injuries or illnesses that are believed to be work-related. Minor injuries may develop into major problems, even if the worker does not envision the long-term consequences. Very often, what starts off to be a minor event develops into a major problem, and if a minor event was not reported promptly, the claim is treated with a high degree of suspicion by the employer, the employer's insurance company, and the workers' compensation agency or court. There is a belief in the injury area that a delay in reporting somehow affects the validity of the claim and the credibility of the claimant.

Virtually all states require prompt reporting of accidents, injuries or illnesses that are believed to be work-related. Minor injuries may develop into major problems, even if the worker does not envision the long-term consequences. If a minor event was not reported promptly, the claim is treated with a high degree of suspicion by the employer, the employer's insurance company, and the workers' compensation agency or court. There is a belief in the injury area that a delay in reporting somehow affects the validity of the claim and the credibility of the claimant.

Failing to give a full and complete description of the symptoms.

Each time you visit a doctor, the symptoms you report are written down in your permanent records. If you are having symptoms in various parts of your body to varying degrees, you must report the symptoms in all areas. If you initially report only the most serious symptom and later make a claim for injuries to other parts of the body, the later claim will be viewed with great suspicion by the insurance company, employer and the court. A statement that you forgot to mention the other symptoms initially because at the time you hurt worse at other points will not carry much weight. The best practice is to always be very thorough and very complete so that if some minor symptom turns out to be the major source of disability at a later date, there is good, solid documentation that the condition has been present from the beginning.

Failure to give an accurate and consistent description of the accident, conditions or activities causing the problem.

A worker is asked to give a description of the accident or the work conditions when filing reports with employers, and also when filing reports with doctors, disability insurance carriers, and a variety of people. If there are differences in these reports, it gives an impression of inconsistency that can lead to suspicion and doubt, and possibly the loss of an otherwise valid claim. To prevent these inconsistencies, write down how things happened and keep a copy so you can be sure to remember all the details. Then, whenever you are asked to report what happened to you, always provide the same, consistent description of the events leading to your injury or illness.

Signing consent forms or other documents provided by your employer or the employer's insurance company.

With all the variations in state laws, there are a variety of forms that workers are presented by either their employer or their employer's insurance carrier as a part of the claims process. You must be very careful about what you sign. Some of these forms contain references to terms that are not commonly used, and you may be agreeing to give up a right that is terribly important under a particular state law. In my home state, people are sometimes asked to agree to vocational rehabilitation counselors and if the wrong counselor is agreed to, the consequences can be devastating. The same can be true for selection of medical examiners. If you do not understand what you are being asked to consent to, you need to get legal advice because the majority of the time those signed documents will be held against you in court.

With all the different states' laws, workers are presented a variety of forms by either their employer or their employer's insurance carrier as part of the claims process. Be very careful about what you sign. Some of these forms contain references to terms that are not commonly used. You may unknowingly be agreeing to give up a right that is terribly important under a particular state law. In my home state, people are sometimes asked to agree to vocational rehabilitation counselors, and if the wrong counselor is agreed to, the consequences can be devastating. The same can also be true for selection of medical examiners. If you do not understand what you are being asked to sign, get legal advice, because the majority of the time those signed documents will be held against you in court.

Exaggeration of symptoms.

Exaggerating the nature and extent of your disability is the worst thing you can do. This occurs innocently in a lot of cases. There is much bad advice to the effect that you have to be virtually helpless in order to recover workers' compensation. This leads to workers giving exaggerated versions of their problems when they are giving statements to insurance representatives, doctors, vocational rehabilitation consultants, etc. The insurance industry regularly hires private investigators to follow injured workers around and check out their situation. If they find you doing something that is inconsistent with your claims of disability, you will be viewed with great suspicion by all concerned, and you may jeopardize your perfectly good claim. You do not have to be helpless or hopeless in order to recover workers' compensation. You do not need to exaggerate your symptoms to the treating physician or other professionals involved in your case.

Failure to document work restrictions.

Very often, problems arise when workers are not certain of their work restrictions, and they do not keep copies of work restrictions their doctors have given them. This may result in very serious misunderstandings and even dismissal for either working above or below restrictions. To protect against possible misunderstandings, always keep your own copy of any work restriction that is turned in to your employer or the employer's insurance company.

Failure to obtain legal counsel in time.

The area of workers' compensation and injuries in general is not as simple and straightforward as one might believe. If you get into a situation where you don't understand what is occurring and you just trust the representatives of the other side, you may very well end up damaging your case beyond repair.

The old adage about being penny wise and pound foolish is very appropriate for these types of situations. People fear that if they hire a lawyer, they're going to have to pay a part of their benefits, even if the lawyer doesn't do anything to obtain those benefits. This is not the practice of first-rate workers' compensation attorneys. In the vast majority of cases, you are not charged unless someone actually does something that benefits you. Good workers' compensation lawyers spend a lot of time advising people and making sure that proper decisions are made so that the long-term benefits will be appropriate.

Trusting the advice of your employer's workers compensation insurance or risk management representative.

You need to understand that representatives of your employer or its insurance company have different goals and interests than you. The adjusters may be polite and pleasant, and you may think their job is to look out for you. However, their job is to close the claim as quickly and as cheaply as the law allows. Don't be misled into believing they are going to get you everything to which you are entitled. You need to understand that representatives of your employer or its insurance company have different goals and interests than you. The adjusters may be polite and pleasant and you may think their job is to look out for you. However, their job is to close the claim as quickly and cheaply as the law allows. Don't be misled into believing they are going to get you everything you are entitled to.