Have you heard that fraud is rampant in workers' compensation claims? You might think so based on popular beliefs. You should know that the incidence of workers' compensation fraud is actually quite low – about 1 or 2 percent. Whether it's just a falsehood that won't die, or it's based on insurance industry smear campaigns, workers who legitimately need benefits may suffer. Read on to find out more about dealing with a work-related injury while under suspicion of fraud.
Denials of Benefits
Workers' compensation insurance companies often provide much-needed help for those who have been hurt as a result of their jobs. Unfortunately, these private insurance companies are for-profit businesses and don't approve claims willingly or easily.
These agencies utilize a number of actions meant to slow down, delay, and deny a worker's claim. For example, if you were not able to locate any witnesses to your workplace accident, you may find your claim routinely denied regardless of all other evidence to support it.
Other common ways claims get held up are allegations of exaggeration of injuries, mistakes on claim forms dealing with dates, names, or times, allegations of off-site injuries, and issues with conflicting information. For example, if your initial claim for benefits stated that you were hurt while walking out to the parking lot, but you told the workers' comp doctor that you slipped on ice in the parking lot, that could be considered conflicting information by the claims adjusters at the workers' comp carrier.
An Unwelcome Intrusion
This practice of claim denial can get personal if your claim involves a serious injury along with a serious amount of money. Video surveillance of work-related accident victims has become common when big claims are involved.
While it's illegal to record you while you are inside your home, your movements are fair game when you visit your doctor, take your kids to school, and spend time on your front porch. The purpose of the surveillance is to catch you performing physical movements that will make your claims look fraudulent. Even innocent acts that are only possible with a lot of pain medication onboard can be misconstrued to look fraudulent.
If your claim has been denied based on unjustified allegations of fraud, speak to a workers' comp lawyer immediately. You are entitled to a series of appeal hearings and having legal support during these activities is vital. Speak to a workers' comp attorney, and get the benefits you deserve.Share
11 May 2019
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