Avoiding these common mistakes will help ensure a successful workers’ compensation claim
The North Carolina workers’ compensation system is designed to provide financial assistance and medical coverage for workers who suffer injuries or illnesses due to their employment.
In a perfect world, filing a claim and receiving the necessary benefits would be a straightforward process. However, the reality is often more complex, involving numerous laws, policies and stakeholders, including employers and insurance companies.
Mistakes made during the process can have significant consequences. Even seemingly minor errors can lead to a reduced settlement or, worse, an outright denial of your claim. This article aims to guide you through what not to do after sustaining a work-related injury, helping you avoid common pitfalls that could jeopardize your workers’ compensation benefits in North Carolina.
Top mistakes to avoid after a work injury
1. Assuming you’re not eligible for benefits or blindly trusting your employer
Assuming you’re ineligible for workers’ compensation benefits or simply taking your employer’s word for it can be a significant and costly mistake.
It’s important to know that most workers in North Carolina are eligible for workers’ compensation benefits—even those who work part-time—as long as their employer has 3 or more employees. The intent behind the workers’ compensation system is to support injured workers in their recovery, regardless of how much they work.
Sometimes employers, whether intentionally or out of ignorance, may misclassify their workers as independent contractors or simply discourage them from filing claims. While your employer may have good intentions, they might not be well-versed in the specifics of North Carolina’s workers’ compensation laws. Blindly trusting your employer can be a risky move that may leave you without the financial and medical support you need.
For these reasons, it’s critical to do your own research or consult with an experienced workers’ compensation attorney who can help confirm your eligibility and explain your rights under North Carolina law.
2. Waiting to see if you’ll feel better before reporting your injury
Delaying the reporting of a workplace injury in hopes of feeling better can be detrimental for several reasons:
- First, North Carolina workers’ compensation law has strict timelines for reporting injuries to your employer. In most cases, you only have 30 days to inform your employer of your injury in writing. Failure to meet this deadline could result in a denial of your claim.
- Second, the longer you wait to report the injury, the more difficult it becomes to establish a clear link between the injury and your work, thereby weakening your case.
- Third, waiting too long may raise questions about the severity or legitimacy of your injury, making it more likely that your employer and their insurance company will deny your claim.
3. Not seeking immediate medical care
Failing to seek immediate medical care after a workplace injury in North Carolina can have serious repercussions on your workers’ compensation claim.
First and foremost, delaying medical attention can be detrimental to your health, as some injuries may worsen over time if not promptly treated. Beyond that, waiting to get medical care can send the wrong signal to your employer and their insurance company, possibly leading them to question the severity of your injuries.
Insurance adjusters often scrutinize the time elapsed between the injury and when you first sought medical treatment. Any significant delay could be used as evidence to minimize your claim or even deny it outright.
Moreover, your medical records serve as vital documentation of your injury, and the sooner you get medical attention, the more credible and complete those records will be.
Lastly, North Carolina workers’ compensation laws often require you to visit a health care provider approved by your employer or their insurance company. By not seeking immediate medical care, you risk non-compliance with these regulations, which could also jeopardize your claim.
4. Using your own doctor without authorization
Employers and insurance companies often have designated health care providers for workers’ compensation cases. When you go outside of this network without prior approval, you risk not getting reimbursed for the medical expenses you’ve incurred. This can put you in a financially challenging situation and give the insurance company grounds to question the validity of your claim.
Additionally, medical records and opinions from an unauthorized doctor may not carry as much weight in your claim process as those from an approved health care provider. This can make it more difficult to prove the extent of your injuries and could ultimately result in a reduced settlement or denial of your claim.
If you feel that your designated health care provider is not addressing your medical needs adequately, it’s crucial to consult with an experienced workers’ compensation attorney rather than taking matters into your own hands by seeing an unauthorized doctor.
5. Lying or exaggerating about your injury
Insurance adjusters and investigators are trained to spot inconsistencies or exaggerations in claims. They may employ various tactics, such as surveillance, background checks, and a review of medical records, to validate the claims. If caught lying or exaggerating, not only will you likely lose any benefits you might have received, but you may also be liable for fraud charges.
In North Carolina, workers’ compensation fraud is a criminal offense that can result in fines and imprisonment. Dishonesty could also severely damage your credibility in any legal proceedings and affect your eligibility for benefits in the future.
Even if lying or exaggerating seems like it could offer a short-term advantage, the long-term risks far outweigh the potential benefits. To protect your rights and ensure you receive the compensation you’re legitimately entitled to, it’s critical to be honest and accurate when reporting your injury and during the entire claims process.
6. Not following the doctor’s orders
Insurance companies often scrutinize your medical records and treatment compliance closely, and any deviation from recommended treatments, skipped appointments, or failure to take prescribed medications could be red flags.
Non-compliance with medical advice not only hampers your recovery but also provides grounds for insurers or employers to argue that you’re not as injured as you claim to be or that you’re not committed to getting better. Such behavior often leads to a reduction or denial of your benefits.
For a successful claim, it’s crucial to follow all medical directives and keep detailed records to prove your compliance. Doing so will help demonstrate your commitment to healing and returning to work, reinforcing the legitimacy of your claim.
7. Using social media (even if you don’t mention your injury)
Using social media while you have an ongoing workers’ compensation claim can be risky, even if you don’t mention your injury directly. Insurance companies and employers often monitor social media accounts to look for inconsistencies between what you’ve claimed and your online activities.
For example, posting photos of you engaging in physical activities could contradict your claims of being severely injured, leading to reduced or even denied benefits. Additionally, social media use may provide timestamps and location data that could be used to challenge your account of events or timelines. Comments or discussions with friends and family could also be misinterpreted or taken out of context, further complicating your claim.
In most cases, it’s best to avoid posting anything on social media during your recovery to protect your claim. Even if you adjust your settings so that only close friends and family can see your posts, the reality is, there’s still a risk of your posts being used against you.
Was your claim denied? Here’s a detailed overview of the workers’ compensation claims appeals process in North Carolina, and what to expect after contacting an attorney.
8. Failing to keep track of your medical-related expenses
Failing to keep a meticulous record of expenses associated with your work injury can be a costly mistake when filing a workers’ compensation claim. While it may seem obvious that you should document major costs like surgery or physical therapy, many people overlook smaller expenses that are reimbursable, such as mileage for medical appointments.
In North Carolina, you’re entitled to be reimbursed for mileage traveled to and from medical visits, pharmacy trips and other injury-related activities. These seemingly minor costs can accumulate over time and become quite substantial.
To maximize your claim benefits, maintain a comprehensive log of all incurred expenses, including gas mileage, parking fees, and even tolls. Store all receipts and document each trip’s purpose. By keeping an organized record of these smaller expenses, you stand a better chance of receiving the full compensation you’re entitled to, helping to alleviate the financial burden of recovery.
9. Overlooking vocational rehabilitation services
Vocational rehabilitation services aim to help injured workers return to the workforce, either in their previous field or a new one, if their injuries prevent them from resuming their former jobs. These services can include job retraining, resume building, job placement assistance, and even educational programs aimed at acquiring new skills.
Many injured workers are unaware that vocational rehabilitation is often covered under workers’ compensation benefits. By not taking advantage of these services, you may be inadvertently prolonging your return to work and potentially reducing your compensation benefits in the long term.
Utilizing vocational rehabilitation not only aids in your career but can also demonstrate to insurance companies and legal entities that you’re actively participating in your recovery. This proactive approach could positively impact your workers’ compensation claim.
10. Accepting a settlement offer after a serious injury without consulting an attorney
Accepting a settlement offer for your workers’ compensation claim without consulting an attorney can be risky, especially in cases involving serious or catastrophic injuries.
The truth is, insurers are in the business of minimizing payouts, and their initial settlement usually isn’t enough to fully account for all the costs and implications of your injury. These could include ongoing medical treatment, physical therapy and the loss of future earning potential.
A seasoned workers’ compensation attorney will have the expertise to evaluate the fairness of a settlement offer in the context of your specific situation. They can help you understand the full scope of your current and future medical needs and financial losses, including those that may not be immediately apparent.
An attorney can also assist in negotiations with the insurance company, potentially resulting in a higher settlement amount that more accurately reflects the long-term consequences of your injury.
Get help with your claim from an experienced North Carolina workers’ compensation attorney
If you’ve suffered a work injury in Charlotte, don’t leave your claim and your compensation up to chance. The experienced work injury attorneys at Wilder Pantazis Law Group can help you navigate the workers’ compensation process and negotiate with your employer’s insurance company to get you maximum compensation for your injuries.
Contact us today to learn more about your rights with a free, no-obligation consultation.