5 Work Related Injuries Mistakes That Can Delay Benefits
A workplace injury can leave you dealing with medical treatment, time away from work, and uncertainty about your income. In the middle of that disruption, mistakes in reporting an injury or handling a workers’ compensation claim can create additional problems.
Kentucky workers’ compensation law provides benefits for qualifying work-related injuries, but injured workers must follow important notice, medical, and claim requirements. Understanding common mistakes can help you avoid preventable complications.
At Spencer Law Group, we help injured workers understand their rights and address problems that arise during workers’ compensation claims. From our office in Lexington, Kentucky, we serve clients in Bowling Green, Covington, Louisville, Owensboro, and Hopkinsville. Contact us today to discuss your work-related injury.
1. Delaying Initial Reporting and Medical Evaluation
Waiting to tell your employer about an injury can jeopardize a workers’ compensation claim. Kentucky law generally requires notice of a workplace accident to be given to the employer “as soon as practicable.” The notice should identify the accident and resulting injury. Although Kentucky law recognizes limited circumstances in which delayed notice may be excused, you should not assume a delay will be harmless.
To protect your claim, keep these steps in mind:
Notify your employer promptly: Report the accident and injury as soon as practicable. Written documentation can also help establish what you reported and when.
Keep copies of relevant records: Save incident reports, emails, medical records, and other documents related to the injury.
Describe your symptoms accurately: Tell your medical provider about the symptoms and body parts affected by the workplace accident rather than minimizing or exaggerating them.
Follow appropriate medical treatment: Attend appointments and follow reasonable treatment recommendations related to your work injury.
Prompt reporting also allows your employer and its insurer to investigate the accident and begin addressing the claim.
2. Mishandling Communications With the Insurance Carrier
After an injury is reported, the workers’ compensation carrier may investigate the claim and request information. Kentucky regulations require carriers to investigate work-related injury claims and inform workers of additional information needed before a claim can be accepted.
A mistake at this stage is treating every request casually or providing information without understanding why it is being requested. You should answer truthfully, but you should also understand your rights before providing a recorded statement or signing documents you do not understand.
Medical authorizations also require more nuance than the original draft suggested. Kentucky’s Form 113, for example, contains a medical-information release covering information reasonably related to the claimed work injury or disease. Rather than categorically refusing medical releases, review what information a particular authorization permits before signing it.
If you are unsure how to respond to an insurer’s request, our work-related injury attorneys can help you understand the claim process and determine how to protect your interests.
3. Providing Incomplete or Inaccurate Information
Workers’ compensation claims depend on information about how the injury occurred, what injuries resulted, your employment, medical treatment, and time away from work. Incomplete or inaccurate information can create questions that require additional investigation.
Keep your information consistent and accurate throughout the process:
Identify potential witnesses: Keep the names and available contact information of people who witnessed the accident or its immediate aftermath.
Describe what happened accurately: Explain the circumstances of the accident without guessing about facts you do not know.
Track time away from work: Maintain records of work missed because of the injury and any work restrictions provided by your medical provider.
Review documents before submitting them: Check names, dates, employment information, and other details for errors.
Avoid assuming that every workplace injury involves an unsafe condition or someone else’s fault. The circumstances of the accident matter, but you should accurately document what happened rather than trying to identify a hazardous condition that may not have existed.
4. Failing to Follow Kentucky’s Medical-Treatment Procedures
Another mistake is assuming that you can receive treatment from any provider without considering workers’ compensation requirements. Kentucky generally allows an injured employee to select a designated physician, but specific rules govern the designation and coordination of treatment.
Except for emergency care, treatment is generally coordinated through the designated physician, who may refer you to other providers. Kentucky regulations require you to identify the designated physician through Form 113 within 10 days after treatment with that physician begins.
Ignoring these procedures can create disputes over medical treatment or payment. Keep copies of medical forms, know which physician is designated for your claim, and ask questions before changing providers or pursuing treatment outside the applicable process.
Following the medical-treatment requirements also creates a clearer record of your injury, treatment, and progress. That documentation can become important if questions arise about the extent of your injury or the medical care connected with it.
5. Assuming Benefits Will Continue Without Addressing Claim Problems
A final mistake is ignoring notices, information requests, or disputes because you assume the claim will resolve itself. Kentucky regulations require a carrier to advise an injured employee whether a claim is accepted or denied and to provide specific reasons for a denial. The carrier must also identify additional information it needs before accepting a claim.
Pay attention to correspondence about your claim and respond appropriately when information is requested. If benefits are delayed, denied, or terminated, determine why rather than assuming you simply have to wait.
Kentucky also has specific rules governing income benefits. For example, income benefits are generally not payable for the first seven days of disability unless the disability lasts more than two weeks, in which case benefits may be payable from the first day. Understanding rules like these can help you distinguish a statutory waiting period from a problem that requires further action.
Work With Spencer Law Group After a Workplace Injury
A workers’ compensation claim can become more difficult when notice, medical-treatment requirements, documentation, or insurer communications are mishandled. Knowing what Kentucky requires can help you avoid mistakes that may complicate or delay the benefits process.
At Spencer Law Group, we help injured workers understand the workers’ compensation process and address issues affecting their claims. We serve clients in Lexington, Bowling Green, Covington, Louisville, Owensboro, and Hopkinsville. If you were injured at work and have questions about your claim or benefits, contact our Kentucky work-related injury attorneys today to schedule a consultation and discuss your options.