Nov, 2017

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posted in Wilka, Welter & Ash LLP Law Blog.

The Major Pitfalls of a Workman’s Comp Suit

The Major Pitfalls of a Workman’s Comp Suit

If you’ve suffered a personal injury in the workplace, it’s important to understand the fundamentals of a workers compensation claim, and you main end up needing a Sioux Falls workers compensation attorney in order to have your claim taken seriously. The first thing you need to know is that your employer is likely insured against workers compensation claims, so you won’t necessarily be dealing with the company’s personal attorneys but rather the insurance company’s attorneys. While there may be penalties for the employer if the claim should be upheld, both the employer and the insurance company have a vested interest in making the problem your fault. Since there are some unscrupulous employees that abuse the process, there is going to be an in depth inquiry, and in all likelihood, a worker may have to submit to a drug test.

“Just because an injury happens on the job, doesn’t mean that you’re automatically entitled to collect against your employer’s insurance,” says one workers compensation attorney from Sioux Falls. “It’s important that when you see a doctor, if he says you have an illness and it’s likely related to your job, that you report that to Human Resources. If you were injured on the job, tell your doctors. They need to know that, and that information can be referenced later when you’re making the claim. Remember, your employer has insurance to cover these things and it’s there for a good reason. But sometimes the insurance companies can be a bit prickly about paying out a claim. Insurance is a business, and the fewer claims they pay out, the more lucrative the business is.”

“It’s generally when employees aren’t on the ball about telling their doctors about how they got the injury and being upfront with the HR department about what’s going on that insurance companies either get suspicious, or see an opportunity to deny a claim,” he continued. “Another thing that happens to employees injured on the job is that their employer tells them that the accident was their fault and so they’re not covered. That’s a lie. Worker’s compensation is no fault insurance so even if you slip on your own banana peel, you should be covered by the company’s insurance. There’s a limit to just how stupid you’re allowed to be and still make the claim, but you shouldn’t believe your employer if they tell you that it’s your fault for your not being covered.”

“And one instance where workers compensation insurance will not pay out is when an employee is found to be drunk or high on the job,” he said. “Most employees will require a drug test after a claim is made, so stay sober at work, because if you don’t, you’re not going to qualify for worker’s comp.”