I have been practicing Workers Comp Law for 30 years as a Virginia Workers Compensation Lawyer and these are the mistakes I see claimants repeat again and again which often means a denial of their comp claim. FIRST, many claimants fail to report an injury right away thinking it is trivial or that they will shake it off. Many claimants do this because they don't want to be fired. However, many employers have a policy requiring reporting of an injury immediately to a superior within 24 hours. If a claimant violates this policy, the employer will usually deny the claim. Also, the Virginia Workers' Compensation Law requires reporting of an accident to an employer within 30 days of the accident. SECOND, many claimants delay going to a doctor for an injury. This can be a big mistake because most employers only acknowledge an injury if the claimant goes to a doctor. Moreover, the longer one waits to go to a doctor, the more difficult it can be for the doctor to link the impairment to the accident. THIRD, most claimants provide the adjuster a recorded statement about the accident without obtaining professional advice. If there is a problem with the claim, the adjuster will use the recorded statement to pin down the claimant's version of the story without the claimant knowing he or she even has a problem. FOURTH, many claimants think they can switch doctors. The law requires the employer or its insurer to provide a panel of three doctors to the claimant. From that panel, the claimant is required to pick his/her doctor. Once this doctor is chosen then the doctor becomes the treating doctor for the claim. It is then very difficult to switch doctors. FIFTH, many claimants settle their claims without knowing the real value of the claim. Every claim has the potential for lifetime medical coverage and 500 weeks of compensation in Virginia. The claimant needs to speak to a knowledgeable workers' compensation attorney before settling any claim. SIXTH, many claimants go to a hearing without an attorney. They do not know the insurance company will always be represented by an attorney. They do not know their claim may involve technicalities that will lose them their claim. Many think if they lose they can always appeal and then obtain an attorney. Of course, this violates the old saying that says "he who represents himself has a fool for an attorney." They also do not know that mistakes made at the hearing can rarely be corrected on appeal because no "new evidence" is allowed on appeal. SEVENTH, many claimants think the claims adjusters or the insurance company nurse or the insurance company rehabilitation worker is working for them. They don't realize they are in an adversarial relationship and that any confidences they volunteer can be used against them. EIGHTH, even if the insurance adjuster accepts the claim the claimant has to be careful. The adjuster will be sending the claimant an AGREEMENT TO PAY form. The claimant has to check to make sure all the injuries he/she has suffered in the accident are recorded on the agreement form. If they are not, then the injuries left off can be lost if they are not added to the claim within two years of the accident. For example, often an arm or shoulder injury will mask a neck injury. If the neck injury is not recorded, then it can be lost even if the doctor is treating the neck injury. NINTH, many claimants do not realize the insurers may continue to investigate a claim even after the claim has been accepted. Especially, if the claimant is on compensation for "chronic pain," the insurers will often have the claimant secretly videotaped hoping to show the claimant doing activities demonstrating he/she is not disabled. TENTH, many claimants do not realize once they are released to light duty work the insurers will try to have the claimants placed in light duty work. They will first try to place the claimant back with the original employer. Next, they will hire a vocational rehabilitation specialist to place the claimant in alternative light duty work. Many claimants do not realize they have to be available from 9-5 five days a week to do a job search with the job specialist. Missed appointments or any failure to cooperate can result in a suspension of compensation. IN SUMMARY, many of the above mistakes listed above can be avoided if the claimant consults early on with an attorney who is a specialist in Virginia workers' compensation law. This may be considered AN ADVERTISEMENT or Advertising Material under the Rules of Professional Conduct governing lawyers in Virginia. This note is designed for general information only. The information presented in this note should not be construed to be formal legal advice nor the formation of a lawyer/client relationship. |
