The right attorney can fight for all the compensation you deserve.
Workers' compensation is supposed to be straightforward. You're hurt at work, and the insurance company pays your medical expenses and a percentage of your lost income, as well as certain other benefits if you sustain a permanent injury. The reality, however, is often more complicated. All too often, insurance companies use shady tactics to reduce, delay, or deny claims to protect their bottom line – typically at an injured worker's expense.
Here are the workers' comp insurance companies' most common tactics, and how the experienced attorneys at O'Malley & Langan can help you fight back.
Shady Tactic #1: Delaying your claim to put pressure on you
As the law is written with the understanding that injured workers need these benefits to make ends meet and protect their health, the insurance company is required to meet strict deadlines. Unfortunately, like most administrative processes, the workers' compensation system doesn't always move quickly.
Some insurance companies deliberately delay or slow-walk claims. They may request burdensome amounts of paperwork or use complicated procedures that drag out the process. This pressures injured workers to return to work, often before they are medically cleared, or to accept a smaller settlement than they deserve because they need the income.
"Although using processing delays as a negotiating tactic is illegal in the Pennsylvania workers' compensation system, that doesn't mean the insurance companies don't do it," says O'Malley & Langan Founder and Senior Partner Todd J. O'Malley. "Luckily, once you hire an experienced workers' compensation lawyer, insurance companies realize they can't get away with those tricks. If they try, we'll hold them accountable."
Shady Tactic #2: Taking a recorded statement
The workers' comp insurance adjuster might ask you to provide a recorded statement. They could even imply it's necessary to process your claim. It's important to understand, and this applies to all requests you receive from an insurance company, they actually want your statement to protect themselves, not you. That's why it's critical to speak with an experienced lawyer before you say anything to the insurance company.
"The problem with a recorded statement is that it's often requested while you're in pain and don't yet understand your rights," says attorney Mary Anne O. Lucas. "Plus, any statement can be misrepresented or taken out of context and used against you. We always recommend speaking with one of our attorneys before agreeing to give a statement."
Shady Tactic #3: Pushing you to accept a light duty work assignment when you're not ready
The insurance company might want you to return to work on light duty – a less physically demanding role – while you continue your recovery. Although there are situations in which light duty can be beneficial for both the employee and the employer, there are also many scenarios in which accepting light duty work can be used against you.
If you're cleared for light duty work and refuse, the insurance company could deny your claim on that basis, even if you are truly unable to work. Or, they may assign you a light duty role that's just as physically demanding as your previous job. In these situations, your workers' compensation benefits could disappear while you're still unable to work at full capacity. An experienced workers' compensation lawyer will push back, advocate for your rights, and make sure your benefits align with what you can and cannot do.
Shady Tactic #4: Hiring a private investigator to spy on you
Workers' comp insurance companies are notorious for hiring investigators to follow injured workers and gather information that can be used to deny a claim. If an investigator observes you engaging in certain types of activities, it could help them argue that you're faking or exaggerating your injuries. They can scan your public social media profiles, and even interview your neighbors in search of information.
"The main thing an investigator looks for is a violation of your doctor's orders. If you're only engaging in activities your doctor has cleared and those activities are questioned in court, your medical records will defend your position," says retired Workers' Compensation Judge and O'Malley & Langan attorney Joseph Grady. "So, always follow your doctor's instructions, especially in public places. It's not only best for your health, but it also protects your rights. And remember, the only people with whom you should discuss your injuries are your physician and your lawyer."
Contact one of our workers' compensation attorneys to protect your interests.
The insurance company's primary goal in a workers' compensation claim is to minimize their own costs, which means paying you as little as possible. As your attorney, we'll advocate for your rights so you receive the benefits you deserve under Pennsylvania law.
If you'd like to discuss problems you're having with workers' compensation, contact us for a free, no-obligation consultation.
