Navigating a workers' compensation claim can feel overwhelming, especially when you're focused on recovering from an injury. Unfortunately, common mistakes can derail your claim and prevent you from receiving the compensation you need to heal and move forward. At Orlando R. Murillo, we understand the challenges injured workers face and are here to guide you through the process. Below, we outline the most frequent mistakes and how to avoid them to ensure your claim stays on track.
1. Delaying Reporting the Injury
One of the most critical steps in a workers' compensation claim is reporting the injury promptly. Florida law requires employees to report work-related injuries to their employer within 30 days of the incident. Failure to meet this deadline can result in a denied claim, leaving the injured worker without any compensation.
Many workers hesitate to report injuries because they think the injury is minor or will heal on its own. However, even seemingly insignificant injuries can worsen over time. Delaying the report of an injury may not only harm the worker’s health but also weaken the credibility of the claim.
- Action Plan: Always report an injury as soon as possible, even if it appears to be minor. This ensures that you meet legal requirements and have the necessary documentation if the injury becomes more serious.
2. Failing to Seek Immediate Medical Attention
Another common mistake is failing to seek medical attention immediately after the injury occurs. Some employees believe that if the injury is minor, they do not need medical treatment. However, waiting to see a doctor can negatively impact the claim by giving the insurance company a reason to argue that the injury is not severe or is unrelated to the workplace incident.
Furthermore, some workers may choose to see their own doctor rather than a physician authorized by their employer’s insurance provider. This can also harm the claim, as workers' compensation laws typically require employees to see a doctor approved by the insurer.
- Action Plan: Seek medical attention immediately after the injury, and follow the proper procedures by visiting an authorized healthcare provider. Always ensure that your injuries are documented, and follow your doctor’s recommendations for treatment.
3. Not Following Doctor’s Orders
Once an employee receives medical care, it is crucial to follow the doctor's treatment plan and recommendations. Failing to attend follow-up appointments, participate in prescribed therapy, or take medication as directed can be interpreted as a sign that the injury is not as severe as claimed. Insurance companies often use non-compliance with medical instructions to deny or minimize workers' compensation benefits.
- Action Plan: Adhere strictly to your doctor's recommendations, attend all scheduled appointments, and follow the prescribed treatment plan. If you are unable to follow the doctor's orders due to complications, discuss alternative treatment options with your healthcare provider and ensure this is documented.
4. Returning to Work Too Soon
Some injured workers feel pressure to return to work before they are fully healed, either because they are concerned about job security or because they underestimate the extent of their injury. However, returning to work too soon can lead to re-injury, complications, or worsening of the existing condition. This can not only delay recovery but also negatively impact the workers' compensation claim, as the insurance company may argue that the worker’s return to work indicates that the injury was not severe.
- Action Plan: Only return to work when your doctor has cleared you to do so. If you are eager to get back to work but are still not fully recovered, discuss light-duty or modified tasks with your employer that align with your current physical capabilities.
5. Inadequate Documentation
Documentation is crucial in any workers' compensation claim. Many employees fail to maintain proper records of their medical treatment, injury-related expenses, and communication with their employer or the insurance company. In the absence of clear documentation, it becomes difficult to prove the extent of the injury and the associated costs.
Additionally, some workers make the mistake of not keeping copies of their injury report, medical records, or other important paperwork. This can complicate the claims process if there are disputes or the need to appeal a denial.
- Action Plan: Keep detailed records of all medical treatments, doctor’s appointments, medications, and related expenses. Maintain copies of all paperwork associated with your claim, including injury reports, communication with your employer, and correspondence from the insurance company.
6. Speaking Too Freely with Insurance Adjusters
After filing a workers' compensation claim, you will likely be contacted by an insurance adjuster who will investigate the claim. While it is important to cooperate with the adjuster, many workers make the mistake of providing too much information or discussing matters that could be used against them.
For example, discussing pre-existing conditions or making offhand comments about the injury (“I’m feeling much better now”) can give the adjuster grounds to deny or reduce benefits. The insurance company’s goal is to minimize its liability, so any information provided will be scrutinized for ways to deny or minimize your claim.
- Action Plan: Be honest with the insurance adjuster, but stick to the facts of your case. It is advisable to consult with an experienced workers' compensation attorney before speaking with the adjuster to ensure that you do not inadvertently harm your claim.
7. Failing to File a Claim on Time
In Florida, workers have two years from the date of the injury to file a workers' compensation claim. However, missing this deadline can result in the forfeiture of benefits. Some workers assume that because they reported the injury to their employer, they do not need to take further action, which can lead to missed deadlines.
- Action Plan: Consult with a workers' compensation attorney to ensure that your claim is filed on time. An attorney can help navigate the legal requirements and ensure that you meet all necessary deadlines to preserve your rights to compensation.
8. Quitting Your Job During a Claim
Some workers may feel discouraged or frustrated during the workers' compensation process and may decide to quit their job while their claim is pending. However, quitting a job during an active workers' compensation claim can negatively impact the outcome. Insurance companies may argue that the worker’s decision to quit was unrelated to the injury or that they are no longer entitled to benefits.
- Action Plan: Avoid quitting your job during the workers' compensation process unless you have consulted with an attorney and understand how it may impact your claim.
9. Misrepresenting the Injury
Exaggerating the extent of an injury or falsifying details about how the injury occurred can have serious consequences. Not only can this lead to a denial of benefits, but it can also result in legal penalties for fraud. Insurance companies conduct thorough investigations, and any discrepancies in your claim can be used to dispute your credibility.
- Action Plan: Always provide accurate and truthful information about your injury and the circumstances surrounding it. Honesty is key to maintaining credibility throughout the workers' compensation process.
10. Not Consulting an Attorney
Many workers attempt to handle their workers' compensation claim on their own, believing it is a straightforward process. However, workers' compensation laws are complex, and insurance companies often have experienced attorneys on their side. Without proper legal representation, workers may not receive the full benefits to which they are entitled.
- Action Plan: Consult with an experienced workers' compensation attorney at Orlando R. Murillo early in the process. An attorney can help navigate the legal complexities, gather necessary evidence, negotiate with the insurance company, and ensure that your rights are protected.
Need Help with a Florida Workers' Compensation Claim? Contact Orlando R. Murillo Today
If you’ve been injured at work, you don’t have to face the complexities of workers' compensation alone. At Orlando R. Murillo, our experienced attorneys are ready to guide you through the process and help you understand your rights. Whether you’re facing a denied claim or unsure of your next steps, we’re here to assist. Serving clients throughout Miami and across Florida, call us at (786) 891-5842 or fill out our online contact form to schedule your free consultation.
Disclaimer: The information provided is not legal advice and does not establish an attorney-client relationship.