There are a lot of reasons why Worker’s Compensation insurance companies deny Worker’s Comp. claims in DC. It is a complex and adversarial system the favors insurance companies. In addition to the DC Worker’s Compensation act, there are 58 chapters of regulations regarding the Worker’s Comp. system in DC, plus hundreds of cases from the DC Court of Appeals to consider.
Here are 3 common reasons insurance companies deny legitimate workers compensation claims in D.C.
1) You Didn't Give Notice Of The Work Injury To Your Employer
If you get hurt at work in DC, notify your employer. Under DC law, you have 30 days to give your employer a notice of your injury, but do not wait that long.
Any delay in notifying your employer of the injury just delays the entire process. Worse than that, it gives the workers comp insurance company an excuse to deny your claim orTo significantly delay your legitimate claim for Worker’s Compensation benefits.
Remember, Worker’s Compensation insurance adjusters are skeptical, they are trained to believe that there is a high percentage of fraud in the system. Many insurance adjusters will think you are faking or malingering or exaggerating you are serious work injury. Not reporting the injury quickly just plays into there bias.
As I say in my book on Worker’s Compensation, it is not enough to tell a coworker that you were hurt at work. You need to tell a supervisor or someone in your HR department. And it is not enough to tell them that your back is hurting or you had an injury to your shoulder, you need to specifically say that the injury happened at work.
2) Your Doctor Does Not Give You A Disability Note Or Work Slip
If you are seriously injured and your doctor says you cannot return to your regular job, and that could mean you cannot do any work at all because of your injuries or you have restrictions and limitations that prevent you from working in your regular duty job, you must get a note from your doctor that indicates your work status. Do not leave your doctors office without it.
Sometimes the doctors receptionist or nurse will tell you they will send it directly to the insurance company. You should not rely on the doctors office to do this. For our clients, we have a dedicated staff member who follows up with doctors offices to get the medical records and disability now our clients to keep their benefits going. It is that important.
Especially at the beginning of a case, the workers comp insurance company will not pay benefits without the medical evidence that you were injured at work and that you cannot work because of the injuries.
3) The Insurance Company Is Denying Your Claim Because They Think You Can't Do Anything About It
Let’s face it, especially in DC, the worker’s compensation system is complicated and favors insurance companies. Unless you have been through it, there is no way to learn it on the fly. Plus, you are up against a fortune 500 insurance company, and adjuster who has probably handled thousands of workers comp claims, plus the insurance company lawyers, investigatora, doctors, case managers, nurses, etc.
Unfortunately, the workers comp insurance company will take advantage of you unless you have an experienced DC workers comp attorney working with you and guiding you through the process to stand up to the insurance company.
The workers comp adjuster and nurse will give you advice and information designed to help limit your medical treatment and the benefits you receive. They will never tell you about the future financial benefits you may be able to receive because of a permanent injury, or that you can choose your own physician and medical specialist, or that you do not have to cooperate with their nurse or have her attend your medical appointments.
You Need An Experienced D.C. Workers Compensation Attorney On Your Side
Our clients work with one of the most experienced DC Worker’s Compensation and trial attorneys In the DMV, who literally wrote the book on D.C. Worker’s Compensation
. Our clients also get our proprietary plan for handling their case together with our confidential playbook so they know what is happening every step of the way.