5 Ways You Can Lose Your Workers’ Compensation Benefits
There are a lot of honest workers injured at work who seek workers’ compensation benefits. But there are also those who are looking to trick the system and get paid for an injury that did not occur at work or one they present as far more serious than it actually is.
Because their job is to separate false claims from honest ones, insurance companies have a number of methods to weed out those lying about their condition.
However, the line can sometimes get blurred and honest workers might find themselves the target of an incredibly persistent insurance agent.
The best way to deal with an insurance agent trying to undermine your case is to hire proper legal representation from experienced attorneys like the Phoenix Workers’ Compensation Attorney Group.
In this article, we are going to list some of the most common ways you could lose your workers’ compensation benefits.
Private Eye Surveillance
Some insurance companies will hire a private eye to track an injured worker while they are under the strict regime suggested by their doctor. If the private eye finds any evidence that the worker is violating the doctor’s orders or is faking their injury, the worker will lose all benefits.
You should be sure not to overstep the limitations your doctor recommended. Not just because you never know who might be watching, but because it could make your injury even worse.
Not Accepting Light Duty Tasks
If the injured worker can no longer perform their regular duty, the employer has to provide a new assignment that doesn’t exceed the doctor’s restrictions. If the worker doesn’t accept their new assignment and does not go back to work, then they can lose their rights to workers’ compensation benefits.
Independent Medical Exam
The insurance company may subject the injured worker to an Independent Medical Exam or IME. The doctor who carries out this exam is chosen by the insurance company to analyze the worker’s reports, case analysis, the course of treatment and other relevant details.
The doctor will also conduct a separate examination of the patient’s injuries, and assess how they affected the worker’s ability to perform their duty.
If the worker does not show for the exam, the insurance company can deny them the workers’ compensation benefits on the grounds of uncooperative behavior.
If the doctor’s analysis proves that the injured worker is capable of performing their duty, the insurance company will cut the benefits to the worker.
Functional Capacity Evaluation
Apart from the IME, injured workers are also often subjected to the Functional Capacity Evaluation. During this exam, the doctor evaluates the worker’s physical abilities and measures their strength by asking them to perform a series of movements or lift a certain amount of weight.
The worker has to be fully cooperative, and if not the examiner can accuse the worker of not cooperating or faking the pain. The insurance company will use this to cut the workers’ compensation benefits.
Missed Medical Checkups and Treatments
If you miss a lot of medical checkups and don’t follow your treatment plan, the doctor might have a hard time determining whether your condition came as a result of the injury or not. If the doctor cannot reach a conclusion due to the fact you did not show up to your appointments, the insurance company will use this to cut your benefits. Therefore, you will also lose the compensation for your treatment.
