When workers are injured on the job, they often rely on workers’ compensation to provide medical benefits and lost wages. However, workers’ compensation insurance companies may not always make it easy for workers to get the benefits they deserve. In fact, they may deploy a number of workers’ comp delay tactics and tricks in an effort to reduce or deny your claim.
As a worker, it is important to be aware of these tactics so that you can defend your rights and access the benefits you need. The workers’ compensation adjuster may try a variety of techniques in order to minimize their financial responsibility from dragging out the claims process to questioning the severity of your job-related injury, including these 6 workers’ comp delay tactics.
6 Common Workers’ Comp Delay Tactics:
1. Lack of Communication
As workers’ compensation claims involve complex legal processes, communication with insurance adjusters is crucial in supporting and expediting the claim. Unfortunately, some adjusters tend to be none responsible at communication, whether intentionally or not.
For example, some adjusters resort to not answering calls or emails in an attempt to hinder a workers’ comp claim. This could mean missing important deadlines and prolonging the resolution of the case. In addition, without clear communication from the adjuster, it can be difficult for workers to understand their rights and gather the necessary documentation for their claim.
In order to protect themselves from workers’ comp delay tactics employed by insurance adjusters, workers should stay organized and keep a record of all communication or lack thereof. If an adjuster is unresponsive, workers should document all attempts to reach out and follow up in writing.
2. Slow Procedural Processing
One of the most common workers’ comp delay tactics employed by insurance companies is to slow down some of the administrative procedures involved in the claim. This tactic can present itself in a number of ways, including for example a request for additional medical documentation or sending the claimant additional forms that are unnecessary for processing the claim.
These can be burdensome tasks for the injured worker, and they can create unnecessary delays in receiving benefits. In some cases, this tactic may also be used to intimidate claimants and discourage them from pursuing their claims.
The employer may be at fault for these workers’ comp delay tactics, as well. For example, in order to file a workers’ compensation claim, certain forms must be filled out and submitted. The employer may try to delay the process by not providing these forms or by telling the employee that they do not need to fill out any forms.
Another common employer tactic is telling the employee that they will take care of everything or saying that the employee does not need to file a claim because it will not be covered. In reality, they end up sitting on the claim for far too long, or they “forget” about it altogether.
These workers’ comp delay tactics can cause a great deal of stress for injured workers, who are often worried about how they will pay their bills and support their families while they are out of work or unable to return to their full earning potential due to their injury. In some cases, the slow processing can even lead to employees returning to work before they are fully healed, which could result in further injury.
In order to avoid these kinds of workers’ comp delay tactics, workers should be as familiar as possible with the workers’ compensation process and what is required of them at each stage and contact a workers’ compensation attorney for legal representation.
3. Disputing the Injuries or Not Authorizing Treatment
As workers’ compensation insurance is designed to provide protection for employees in the event of a workplace injury, it can be devastating when a workers’ compensation adjuster deliberately tries to dispute or downplay the extent of their injuries in order to avoid paying benefits.
Some of these workers’ comp delay tactics include forcing the injured worker to undergo multiple medical examinations by doctors chosen and paid for by the insurance company, claiming that pre-existing conditions are responsible for the injury, or trying to prove that the injury was self-inflicted or caused by a non-work-related event. If an injured worker provides documentation from a personal doctor, workers’ comp adjusters may try to contact the injured worker’s physician directly with “follow-up questions,” when really they are attempting to discredit the doctor’s findings and downplay the severity of the injury.
This can often result in lengthy delays for workers who desperately need medical care and financial support. However, workers’ compensation is designed to provide support for workers injured on the job, regardless of fault.
4. Asking for a Recorded Statement
One of the most common workers’ comp delay tactics is to request a recorded statement. Many workers’ compensation adjusters will request a recorded statement from injured workers as part of the claims process, but giving one can actually do more harm than good.
Adjusters may use a recorded statement to search for inconsistencies or admissions of fault, which could delay or deny a workers’ comp claim. In some cases, they may even intentionally manipulate the recording or twist the worker’s words to serve their own agenda.
It’s important to remember that these adjusters work for the insurance company and not the injured worker, and their ultimate goal is to save their company money. Providing a recorded statement may seem harmless and even helpful, but it can ultimately jeopardize a workers’ comp claim. It’s best to consult with an experienced workers’ comp attorney before giving any type of statement to an adjuster.
5. Offering a Light-Duty Job
Taking a light-duty job while recovering from an injury can seem like a good idea at first, as it allows you to still earn some income while also showing your willingness to work. However, this decision can have negative implications for your workers’ comp claim, as its another one of the most common workers’ comp delay tactics. The workers’ comp adjuster may use your ability to perform the light-duty job as evidence that you are not as injured as you claim to be, leading to reduced compensation or even denial of benefits.
Additionally, if you are performing a job that your injury prevents you from doing safely, you could end up making your injuries worse. It’s important to consult with a workers’ comp attorney before accepting any job offers from your employer or the insurance company.
6. Delaying Payment or Failing to Pay Medical Bills
Once a claim has been approved, the workers’ comp adjuster may try to delay the payment of benefits. They may do this by saying that they are waiting for authorization from their insurance carrier or by claiming that they do not have the funds available at this time.
The employer’s insurance company may also try to avoid paying for certain medical treatments by saying that the treatment is not necessary or that it is not covered by workers’ comp. However, it is important to remember that workers’ comp is designed to cover all reasonable and necessary medical treatment related to a workplace injury.
Kotlar, Hernandez & Cohen: NJ Workers’ Compensation Lawyers
Insurance adjusters use a variety of workers’ comp delay tactics to delay or deny workers’ comp claims. However, injured workers have legal rights that should be protected.
Kotlar, Hernandez & Cohen – The People First Lawyers – have been helping injured workers maximize their New Jersey workers’ comp claims since 1995. Our law firm works tirelessly for our clients to ensure you receive medical treatment, financial compensation, and justice regardless of whether an adjuster or insurance carrier denies the claims or employs other workers’ comp delay tactics. With four board-certified workers’ compensation law attorneys on our team, we are well-equipped to handle your workplace injury claim.
If you’ve been the victim of workers’ comp delay tactics after your work-related accident or occupational disease, contact our office to schedule a free consultation or call us 24/7 at (856) 751-7676.
Tim Search, Partner
Tim Search has more than 20 years of legal experience and is Certified by the Supreme Court of New Jersey as a Workers’ Compensation Law Attorney. His practice focuses on the litigation of workers’ compensation, personal injury, and municipal court cases in the state of New Jersey.