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HOW A WORKERS’ COMPENSATION INSURANCE COMPANY WILL EVALUATE YOUR CLAIM

On Behalf of | Nov 1, 2018 | Workers' Compensation

WHAT TO EXPECT WHEN YOU SEEK WORKERS’ COMPENSATION BENEFITS

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When you have been injured on the job, or have contracted an illness because of exposure to work-related conditions, you have the right to recover workers’ compensation benefits to cover your disability while you are unable to work, and to pay for injury-related medical expenses. However, it’s not a simple matter of filling out the paperwork and starting to receive payments. Your employer will typically have a policy of workers’ compensation insurance that is designed to provide coverage for workplace injuries. Accordingly, to receive benefits, your claim must be approved by the workers’ compensation insurance provider.

It’s important to understand that the workers’ compensation insurance company has a vested interest in paying as little as possible to settle your claim. Insurance companies are for-profit entities and their profits are based on the amount paid out to settle claims. The less paid out, the greater the profit. You can expect, therefore, that the workers’ compensation insurer will typically scrutinize your claim very carefully:

  • In most instances, you’ll have to undergo a medical examination by a doctor chosen by the insurance company. That doctor will usually be looking for ways to minimize or deny your claim. You can still seek an opinion from your own physician and the Workers’ Compensation Board may ultimately have to decide which medical opinion carries more weight.
  • The insurer may seek evidence that your injury was not work-related or that your injuries are not as serious as you claim. It’s common for workers’ compensation insurers to send private investigators to secretly observe you, looking for evidence that you are not disabled. They may also look at the other activities in your life-involvement in recreational sports, for example-and try to argue that your injuries stemmed from those activities.
  • The insurance company may try to get you to take a cash settlement that is substantially less than you need and deserve

CONTACT MALLON & TRANGER

We offer a free initial consultation to people in New Jersey who suffered a needless injury on the job. To set up an appointment with an experienced and knowledgeable lawyer, contact our office online or call 732-702-0333 (toll free) to arrange a meeting. We have offices in Freehold and Point Pleasant.