How to Avoid Losing Worker's Compensation Benefits

It is an unfortunate day when an employee suffers an on-the-job accident resulting in an injury. First of all, there is the pain of the injury. No one wants to get hurt. An accident involves both physical and emotional pain.

Second, it is inconvenient. At best, the injury will require some medical attention. This involves going to appointments with the physician, possible diagnostics, physical therapy, or worse.

Third, when an individual suffers an injury that requires medical treatment, there is often a correlated limitation on work ability. This results in decreased earnings. Ultimately, the injury may leave permanent and long-term consequences that impact both the victim’s work and life.

However, the only thing worse than having a workers’ compensation injury, is losing your rights to workers compensation benefits.

How to avoid losing worker benefitsHow you can lose your rights to workers comp benefits

Over the past two decades the insurance industry has become much more aggressive in attempting to deny benefits based on alleged misrepresentation pursuant to section 440.105(4)(b)(2) Fla. Stat, which makes it unlawful for any injured worker “To present or cause to be presented any written or oral statement as part of, or in support of, a claim for payment or other benefit pursuant to any provision of this chapter, knowing that such statement contains any false, incomplete, or misleading information concerning any fact or thing material to such claim.”

In other words, it’s unlawful for you to provide any important information that you know is false, incomplete, or misleading in a workers compensation case. Violation can lead to the denial of benefits and criminal punishment up to a first degree felony.   The legal ability to deny benefits has led to insurance companies spending extraordinary amounts of money hiring private investigators.

How to avoid losing your benefits

Don’t exaggerate.

Every single statement to a physician or to the adjuster is at risk of being found inconsistent. Adjusters hope that photos or video can be obtained of the injured worker engaged in activity that contradicts the reported activity level of the injured worker. This makes it critical that the injured worker be honest about limitations and abilities. Don’t fall into the trap of over-exaggerating symptoms or impact. Many times the injured worker does this in an effort to be heard by the doctor. However, it ultimately results in the opposite effect and the termination of benefits.

Be honest.

Another area the insurance carrier focuses on is prior conditions or treatment. If the injured worker denies any prior treatment or injury to the affected body part the carrier will deny all future benefits on the basis that the injured worker intentionally misrepresented their medical history in an effort to secure benefits. It is essential that when filling out medical history forms or discussing your history with a doctor that you are accurate. Don’t leave out treatment from the past that resolved. Don’t fail to mention something that you don’t feel is relevant. Even though these things ultimately wouldn’t impact the physician’s opinions the argument is that precluded the doctor from the opportunity to even assess them.

If you are worried about losing your benefits, get a free consultation with a lawyer.

The workers’ compensation system is riddled with landmines that can compromise an injured workers’ right to benefits. The last thing that you want to do is to say or do something that compromises your rights to workers’ compensation benefits. I encourage you to contact an attorney to discuss the specifics of your case and to learn more about the workers’’ compensation system. If you have any questions about an on-the-job injury or any other accident suffered at work, call Michles & Booth immediately to set up your free initial consultation and make sure your rights are protected.


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