The process of filing a workers’ comp claim should be a walk in the park.

You got hurt at work. Fill out some paperwork. You should start receiving benefits.

The reality is far different, however…

The majority of workers’ compensation claims are ruined before they start.

The latest statistics show that less than 40% of eligible workers even apply for workers’ compensation benefits, and of those, a high percentage are denied by insurance companies for all kinds of reasons.

Claim denials are frustrating and all-too-common due to the complexity of the process. Minor filing errors or incorrect procedures can result in delays in receiving benefits and, ultimately, denial of your claim. When your paychecks stop and medical bills start piling up, that’s the last thing you need.

Guess what the good news is…

Those mistakes are completely avoidable with the right knowledge.

What You’ll Learn:

• The Problem With Workers’ Comp Claims
• 7 Mistakes that Kill Most Workers’ Comp Claims (And How to Avoid Them)
• Insurance Companies Fight Back
• Red Flags that Signal Trouble With Your Claim
• The Steps You Need to Take to Protect Your Claim From Day One

The Problem With Workers’ Comp Claims

On paper, workers’ compensation is supposed to be easy. Worker gets hurt at work. Worker gets benefits. Easy.

The problem is that it’s not.

Insurance companies are for-profit entities. The more they can delay or deny your claim, the more money they keep. New research has uncovered that 23% of surveyed workers describe their claims process as negative or neutral, with prolonged processing times being the leading driver of subpar experiences.

Consider this, too – The average total cost for all types of workers’ compensation claims combined, for injuries that occurred in 2021-2022, was $44,179. When accidents that caused serious injuries like motor vehicle crashes in the workplace happen, the average cost jumps to $90,914.

Insurance companies have a financial incentive to deny or delay your claim whenever possible.

This is where most workers blow it.

They don’t realize that hiring a workers comp lawyer in Fresno to represent them from the beginning can prevent 90% of these mistakes. Too many folks try to file and fight for benefits on their own, only to learn too late that they’ve made serious errors.

7 Mistakes that Kill Most Workers’ Comp Claims (And How to Avoid Them)

Let’s get into the 7 most common mistakes that lead to claim denials or delays:

Missing Critical Deadlines

Here’s the big one. You have 30 days to report your injury to your employer in California. Miss that deadline and your claim will get tossed out in most cases.

But wait, there’s more…

Many workers don’t realize the 30 days start when you first become aware of your injury.

Failure to Seek Prompt Medical Attention

You got hurt. It seems minor. You’ll just wait a bit and see if it gets better on its own, right?

Wrong. Failure to get medical treatment immediately after your injury is one of the easiest ways for insurance companies to deny your claim.

Insurance companies will argue that if you didn’t go to the doctor right after the injury occurred, it couldn’t have been serious, and it certainly couldn’t have been work-related.

Failing to Provide Complete & Accurate Information

A single incomplete or inconsistent piece of information can torpedo a workers’ comp claim. Insurance companies will comb through your application and medical records for any reason to deny your claim.

Some common information-related mistakes include:

• Missing or wrong dates
• Vague, inconsistent injury descriptions
• Witness information omissions
• Inconsistent statements between application forms

Here’s the thing that most people don’t realize:

One typo, one missing detail in your paperwork can be twisted by insurance companies to deny your claim. Insurance adjusters are looking for mistakes to pounce on.

Improper Injury Reporting to Your Employer

Informing your supervisor that you hurt your back is not enough. You must report your injury to your employer formally, complete with details about when, where, and how the injury happened, and the names of any witnesses.

Ignoring or Skipping Medical Treatment

Just because you got a doctor’s note right after your injury doesn’t mean you can stop there. You need to follow up on all recommended medical treatment and document it all.

Insurance companies love it when workers skip medical appointments, stop treatment, or fail to follow treatment plans. That’s their go-to argument to deny your claim.

The point is this:

Regular medical treatment for your injury creates a paper trail that proves your injury is legitimate.

Not Understanding Your Rights

Most workers have no idea what benefits they are entitled to under workers’ comp. As a result, they accept low-ball settlements from insurance companies.

Workers’ comp benefits cover more than just medical bills. In addition to medical treatment for work injuries, benefits may include wage replacement, permanent disability benefits, and vocational rehabilitation if you can’t return to your old job.

Trying to Navigate the Process Alone

This is probably the worst mistake of all.

Workers’ compensation laws are complicated. Insurance companies have teams of lawyers and claims adjusters whose job is to delay and deny as many claims as possible. Trying to fight them without professional help is futile.

Many workers wait until their claim gets denied before they finally decide to get legal help. By that point, it’s often too late to recover what they lost.

Insurance Companies Fight Back

Insurance companies don’t just rubber-stamp claims, they fight them.

Insurance companies investigate every claim looking for reasons to delay or deny benefits. Common fighting tactics include disputing that your injury is work-related, claiming you have a pre-existing condition, and contending you failed to report your injury properly.

You might not believe this, but…

Insurance companies routinely hire private investigators to follow and videotape workers with pending claims.

Red Flags that Signal Trouble With Your Claim

Some workers’ compensation claims are inherently more likely to face disputes and challenges. Consider these factors that may flag your claim for further investigation:

• Injuries with no witnesses
• Claims filed following disciplinary action
• Pre-existing conditions affecting the same body part
• Delayed reporting of the injury
• Conflicts between your story and witness accounts

If any of the above are present in your case, getting professional help becomes critical.

The Steps You Need to Take to Protect Your Claim From Day One

Prevention is always the best remedy to stave off claim denials and errors:

Document Everything: Keep thorough records of the circumstances surrounding your injury, medical treatment, conversations with your employer, and the injury’s impact on your life.

Follow Medical Advice: Don’t skip medical appointments, ignore treatment recommendations, and always follow through with treatment.

Be Consistent: Ensure that your explanation of how the injury occurred is the same on all forms and to all people.

Educate Yourself on Your Rights: Research workers’ comp benefits to ensure you get what you’re entitled to and don’t settle for less.

Get Help As Early As Possible: The sooner you get legal help, the better. Don’t wait for the other party to make a mistake.

Time to Take Action

Filing a workers’ compensation claim doesn’t have to be a daunting task, but simple mistakes can cost you thousands of dollars in benefits.

Report your injury to your employer as soon as possible. Get medical treatment right away. Complete all paperwork completely and accurately. Follow through on all medical treatment recommendations.

Most importantly, realize that insurance companies are in business to pay out as little as possible, so having an experienced legal advocate on your side evens the playing field and protects your rights.

There’s too much at stake with workers’ comp claims to let easy mistakes derail your case. With the average cost of workers’ comp claims topping $44,000, proper handling makes a world of difference to your financial recovery.

Don’t let avoidable mistakes sink your workers’ compensation claim. Take the right steps from the get-go and protect your right to the benefits you deserve.