Workers Compensation Claims

Workers Compensation is supposed to be a safety net for employees that are either injured on the job or suffer from disabilities as a result of their working conditions. On the surface, it should be a fairly straightforward process. Unfortunately, insurance companies are more worried about their bottom line than honoring their contractual obligations, and the entire workers compensation process can be a nightmare for those injured on the job.

Every day, injured workers deal with ethically questionable private investigators, second and third opinions from doctors handpicked by the insurance companies and constant delaying tactics. All of these tactics are used to either catch the claimant in legal technicalities so they company can avoid paying the claim, or to frustrate the claimant into giving up. If you have been injured on the job and are unable to work, you will have to face an organized and well-financed team of doctors, lawyers and private investigators just to get barely enough money to put food on the table and provide for your family.

Delay, Delay, and Delay Some More

Most Workers Compensation policies require that the injured party undergo a consultation from a doctor that is on their payroll. These doctors will quite often recommend what is called palliative treatment. This is basically the least expensive and least effective treatment that they can get away with. The purpose of this is to treat the symptoms, which does two things for the insurance company: Firstly, it covers their legal obligation to do something without resorting to more effective and more costly treatments. It also gives them time, which is the most important tool that the insurance companies have.

Once the initial treatment is given, any further treatments are bitterly contested. Every visit to the doctor, every prescription, every recommendation for treatment and every visit to a specialist is going to be protested, appealed, and buried under mountains of paperwork for no other reason then to frustrate the claimant into giving up. One physical therapist described getting enough money from the insurer to cover only a week’s worth of sessions. By the time the paperwork was filled out, the depositions were given and the funds were reluctantly granted for another week’s worth of treatment, so much time had passed that the physical gains made by the patient in the first week were essentially worthless, and he had to start all over again.

These delays also give the insurance companies plenty of time to hire Private Investigators. While that might sound far-fetched and even paranoid, we’ve had plenty of experience in dealing with them. It is their job to keep an eye on you and catch you doing something that would give the insurance company yet another reason to cancel your benefits. Something as seemingly non-important as not limping severely enough could be enough. Catching people in situations that benefit insurance companies is big business for private investigators. It’s developed into such a profitable sideline for them that there are actually textbooks published on the subject.

Insurance companies will also dig into your personal history, where a chapter in your life that is seemingly insignificant could give them the opportunity that they are looking for. One workers comp claimant who was disabled because of 18 years of exposure to toxic fumes at a power plant was denied funds for treatment due to a prior drinking problem. The exposure to the fumes led to liver damage for the patient, and the insurance company in question claimed that the alcohol consumption could just as easily have been responsible, even though the claimant had not touched a drink in over ten years.

Insurance companies also have enormous public relations machines that give the public the perception that most workers comp claims are based on fraud and deceit. We see the results on television and in our newspapers on an almost daily basis. Despite being one of the most profitable industries in the world, insurance companies complain about “frivolous lawsuits” driving them into bankruptcy and raise their rates almost every year, even though their reasons for doing so have very little to do with “frivolous lawsuits” and everything to do with investors and annual profit reports.

It doesn’t have to be like this. Laufenberg, Stombaugh & Jassak, S.C. are well aware of the way the system works. We know that you aren’t trying to win the lawsuit lottery. Your intention is to recover as quickly and as permanently as possible so you can get back to work. That’s what workers compensation is supposed to be for, and unfortunately these days it takes first rate legal acumen to get the insurers to live up to their end of the contract. We know the insurance company tactics, we know the doctors, we know how the investigators work, and we know what it takes to get you the treatment and settlement that you deserve. If you or a loved one has suffered injuries on the job, contact Laufenberg, Stombaugh & Jassak, S.C. today for help.