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Is your workers’ compensation claim “red-flagged?”

On Behalf of | Dec 9, 2020 | Workers' Compensation

Like most people who are employed by someone else, you rely on the idea that workers’ compensation will be there to provide wage replacement income and important medical benefits if you ever get hurt.

Unfortunately, your claim could be stalled or denied due to circumstances beyond your control simply because it sends up “red flags” that employers and insurance companies believe are the signs of fraud.

What can make an insurer or employer think your work injury claim is a fraud?

Here are some of the most common reasons a claim is red-flagged:

  • You waited to report your injury. Maybe you thought you would be fine after you got some rest, but your body actually stiffened up overnight. That may be the only reason you waited to tell your boss about your fall the day before — but your boss may not believe you.
  • Your symptoms aren’t easy to quantify on some kind of medical test. Back pain, headaches and other problems are real consequences of some injuries. But they often can’t be detected on MRIs, X-rays and other tests.
  • You can’t remember the details of your accident. Accidents can happen very fast, and you may be utterly bewildered about how you ended up injured. However, that can make an insurer doubt your story.
  • You got hurt at the wrong time. Accidents don’t happen on a schedule, but your employer does. If you were injured on a Friday or Monday, your employer may think you were actually injured over the weekend. If you were injured just before you were laid-off or right after you were disciplined at work, your employer may believe that your claim is just a ploy.
  • Your co-workers have doubts about your claim. You were alone when the accident happened and the workplace rumor mill is in overdrive. If your boss listens to the gossip, you may have a problem with your claim.

If your workers’ comp claim is denied or delayed without just cause, don’t try to fight the issues on your own. Work with an attorney who takes every case personally. To learn more about your legal options and how we can help, call us at 912-289-0640 or contact our office online.