Avoid Workers' Comp Mistakes

Avoid Workers’ Comp Mistakes

Episode 23:  Kentucky workers’ compensation attorney Jeff Roberts offers advice on how to avoid workers’ comp mistakes that can impact your injury claim.  Often people try to help their cases, but actually end up hurting it or creating unnecessary challenges for your attorney.

Avoid Workers' Comp Mistakes

Failing to Report Your Injury

This is a threshold defense for the company to deny your Kentucky workers’ compensation claim.  It must be overcome before the injured worker can receive any benefits.  If the defense can successfully prove you failed to report your injury to a supervisor or someone higher in the company, the claim can be rejected and basically everything is done, regardless of the injuries.

Under Kentucky law, individuals are required to report the injury, as soon as practical, after the injury.  Don’t be tempted to assume it’s not a “big deal.”  This is one of the most common workers’ comp mistakes. If you experience pain or are having problems doing your work activities, this includes even a minor cut, you need to tell a supervisor.  In the case of a minor cut, it might get infected and lead to other medical issues.  However, if you failed to report it, the company may be off the hook and you could be left with all of the medical bills.

Some companies try to enforce a 24-48 notification policy.  They claim that if you fail to report the workplace injury within this period of time, you don’t qualify for workers’ comp.  In Kentucky, the company policy has no bearing on your workers’ compensation claim.  The law says you have to do it as soon as practical, after the injury.  You have some leeway, but don’t wait too long to notify the company.

It’s important to remember, you need to notify a supervisor or someone “above” you.  Telling a co-worker doesn’t meet your requirement.  Asking the co-worker to tell someone is also risky because they may get distracted and forget to do it.  Nonetheless, if your co-worker tells the supervisor, it may meet the standard for notification.  It’s better to make sure you (or your spouse) do it yourself.

If you seek medical treatment, it’s a good idea to have your medical provider document you’re there due to a workplace injury.  Your medical records will be an important collection of evidence supporting your Kentucky workers’ compensation claim.

Don’t Skip Appointments

It can be harmful to your claim if for some reason, you decide to skip a doctor’s appointment or a physical therapy session.  The defense can claim you failed to follow medical advice.  This can severely limit the value of your claim and the benefits you ultimately receive.  The doctor can claim your missed therapy sessions have cause your healing to take longer.  This can also enable the company to stop your temporary total disability (TTD) payments. 

You Don’t Have to See the Company Doctor

Under Kentucky law, you have the right to see a medical provider of your choice for your workers’ compensation injury.  Some companies try to convince the injured worker that he/she has to see the company doctor.  This is false.  In reality, the doctor may downgrade the extent of your injuries or your impairment rating to benefit the company that is sending them a steady stream of patients.  For this reason, you may want to begin with your family doctor (i.e. primary care doctor) who can refer you to a specialist, without regard to the company’s interests.

If the employer has a managed care plan, they can require you to see a doctor who participates in the plan, but normally you get to choose which of the doctors you’ll visit.

Avoid Skipping or Not Finishing Your Medication

If you’ve been injured at work, you may have prescriptions for medications to help treat the symptoms of your injuries.  Some people get worried about the co-pays or other issues and think they’ll save money if they don’t fill a prescription or don’t finish the medicine as directed.  If reality, this can also harm your workers’ compensation claim.

In Kentucky, as long as your treatment and medication is for the work-related injuries, and they are reasonable, there are no co-pays or deductibles.  The injured worker will not be out of pocket for the treatment. 

It’s possible that you get a prescription filled, before the claim has been fully set up in the system, so the pharmacy may ask for a co-payment.  Keep your receipt and you can get a refund for that expense.

If You Have Questions or Concerns, Contact Your Attorney

It’s always best to speak with your attorney before you take drastic actions or decide to change doctors.  Kentucky law has a gatekeeper policy.  This is the person who can help get you referrals or other treatments.  You are only allowed to change this gatekeeper 1 time, without the insurance company’s approval.  Again, don’t make a drastic change without informing your workers’ compensation attorney, beforehand. 

The gatekeeper can be your family doctor or another treating physician.  You need to understand that the company may try to designate the company doctor as your gatekeeper.  It can be confusing.  This can also make it difficult to get to a specialist or a different specialist.

Important Information about Safety Violations

Here’s an important consideration related to avoiding workers’ comp mistakes. In Kentucky, if your workplace injury is due to the company or a co-worker violating a safety statute or safety policy of the employer, your benefits can be increased by 30%, for that safety violation. 

When you give notice to your supervisor about the initial injury, be sure to specify that it involved a safety violation.  You should document this because it’s extremely important to the value of your claim.

It’s important to understand that if you violated a safety standard and it resulted in your injury, your benefits can be reduced by 15%.  Following safety guidelines and standards is always the best course of action.

For more information, visit www.JeffRobertsLaw.com. This podcast is meant to provide information and is not legal advice.  Jeff’s principal office is located at 509 Main Street, Murray, Kentucky.  Co-host Jim Ray is a non-attorney spokesperson.  This is an advertisement.