Your employer has one motivation for disputing your workers compensation claim: money. Like any insurance product, employers pay premiums for their coverage, and that is affected by what’s paid out in claims. Just as automobile accident claims make your car insurance go up, workers compensation benefits will increase the expense of your employer’s premiums.
Under workers compensation law in Cincinnati, some typical reasons for denying a claim include: not suffering a real injury, having an injury that did not take place at work, getting unnecessary medical treatments, and sustaining an injury that did not require time off from work.
For some injuries, such as carpel tunnel syndrome, or depression, determining the seriousness or validity of an injury can be tricky. This is why it’s best to work with a job accident lawyer who understands the subtleties of workers compensation to make the best case.
The Advantages of Hiring an Attorney Early
It’s common for injured employees to go through the worker’s compensation process on their own, up until the point at which they receive an unfair settlement offer. Hiring a workers comp attorney at this late stage of the process often makes it more difficult to increase your settlement. While an attorney can be helpful at any point during the workers comp process, it is always better to consult with one soon after the injury occurs. If you’ve been injured, consider speaking with a professional from the start. This will allow ample time to build a strong case and will help ensure that you make no mistakes that could jeopardize your settlement.
Can a Work Injury Lawyer Increase My Settlement Award?
Yes, an experienced work accident law firm can usually help you receive a much larger settlement than if you were to go through the claim process on your own. An attorney understands what evidence and documentation you need to increase your injury award. Many workers receive an unfair offer, not because they aren’t eligible for a large settlement, but because they fail to provide adequate documentation. They also may not seek the right kind of medical treatment and diagnoses needed for the insurance companies to take their claims seriously.
What to Do If Your Claim is Disputed
If your workers comp claim has been denied, contact the BWC or self-insured employer’s workers compensation administrator to find out why and how long you have to file an appeal. Next, hire a workers’ comp lawyer to prepare your case. The laws for workers comp were established to protect the rights of the worker. If you need to take the issue to court, contact Clements, Taylor, Butkovich & Cohen, L.P.A. for a free consultation with a workers compensation attorney.
The good news is, many claims that were initially rejected by the BWC are won and awarded upon appeal. A substantial percentage of all initial workers’ comp claim filings are rejected. Do not lose hope if your claim was among those that were not immediately approved.
Given the finite budgets of the workers’ compensation funding pool, the BWC can only fund a certain percentage of claims. With that in mind, bear in mind that the BWC employees reviewing claim applications are notoriously detail-oriented. Even the slightest misstep can cause an entire claim to be thrown out – and there are countless opportunities for missteps in the application process.
With the help of a skilled attorney who is familiar with the details of workers’ comp benefit funding, you can create an appeal that will stand a better case of making it past the discriminating eyes and fine-toothed combs of the bureau.
Was Your Workers Comp Claim Denied? Let Us Help.
In Workers Compensation filings, many claims are denied or disputed. You are not alone. Avoid the mistake that many people make in that situation. Don’t just accept the initial ruling and continue to pay hefty bills for medical care and treatment. Get a Cincinnati workers comp lawyer on your side and defend your claim.
There are four categories of injury that are generally not covered under Ohio Workers’ Compensation. Here is a list and brief summary of each:
- Psychiatric Conditions – a mental health concern is covered by workers’ comp when it arises from a sexual assault at work. In all other circumstances, a mental health problem will only be covered if it’s caused by a separate, covered injury.
- “Natural Deterioration” – Workers’ compensation is not insurance against aging. That is why the law excludes from workers’ comp coverage “injury or disability caused primarily by the natural deterioration of tissue, an organ, or part of the body.” In some cases, it may take significant medical examination and analysis to determine whether a condition is the result of “natural deterioration” or from a circumstance directly tied to the workplace.
- Pre-existing Conditions – Only injuries actually sustained at work can be covered Workers’ comp is not insurance for injuries that existed before the employee arrived at work. However, if a workplace injury substantially aggravates a pre-existing condition, then the injury may be covered. To avoid someone trying to take unfair advantage of this rule, the law provides that the substantial aggravation “must be documented by objective diagnostic findings, objective clinical findings, or objective test results.”
- Company Team Building, Softball Games, etc. – Many employers encourage employees to participate in company-related recreational and fitness activities and sign a waiver upon doing so. When employees join in, any injuries they sustain in the activity will not be covered by workers’ comp.
Worker’s Comp Attorneys Advocating for Your Rights
At Clements, Taylor, Butkovich & Cohen, L.P.A, we understand your legal rights and we will fight for them. Our worker’s comp attorneys have been recognized by the U.S. News & World Report in the top tier of Best Lawyers® in Cincinnati. Your attorney will be your primary source of contact and will walk you through every aspect of the legal process so you understand your rights. Most of our work is taken on a contingency basis, so we only win when you do too. We have decades of experience and have won considerable awards for our clients. Take a look at our testimonials page. Let’s get you every cent you are entitled to for the benefit of your family.