All too often I speak to injured workers about their potential workers’ compensation claims months after they were injured. Whether it is because they did not believe their injury was too severe, or whether their employer promised them help with their injury, many injured workers choose a “wait and see” approach when determining whether they need to file something with the employer or the insurance company.
The best settlements in my experience are in cases where the injured worker sought proper documentation from the very beginning. In the absence of documentation, the employer and insurance company are able to challenge the injured worker about what happened when. The Industrial Commission determines a claimant’s credibility in large part about what the documents from early in the case show.
There is a great deal of lawyer advertising in the public – on TV and on the radio – where lawyers promise fight to get big pay days. Having an aggressive attorney that is willing to work is an important help in trying to get a good result in a workers’ compensation claim. However, a good attorney should also be willing to help “build the record” for their client. This means, as soon as possible in the case, an attorney should want to review documents that the injured worker needs to turn in to the employer or the treating physician. Clear communication is key so that all the sources of evidence an insurance company uses to determine the compensability of a claim align with the injured worker’s story.
Without further ado, here are 7 things every injured worker should do within 3 days of being injured at work:
- Report the accident and injury to the employer: Many larger employers have specific instructions in their employee handbooks about how injuries should be reported. Sometimes it should be reported to a supervisor or a safety manager. Whatever the employee policy dictates, the injured worker should notify some member of management that they were injured at work and provide details about what happened and the symptoms they are feeling from the injury. It does not matter that the injury does not seem that severe at first. You cannot go back in time to report an injury timely. The best reports are signed incident reports or emails that the injured worker keeps a copy.
- Get medical treatment: I have seen many employers argue that the injury really occurred during the time period from when the worker claims injury to when the worker first gets medical treatment. Delays in treatment raise questions about when an injury happened. A Friday afternoon injury and the first doctor visit is Monday? You can bet the insurance company will want to know what the injured worker was doing during the weekend. The most helpful medical records clearly lay out what caused the injury in addition to where and when it happened. Make sure the nurse or doctor that takes the history of the injury are exact on what happened. IMPORTANT – The injured worker should also get an out of work note or work restrictions as soon as possible after an injury if it is appropriate!
- Take the drug test: Many, many, many claims have been denied because the employer has accused the injured worker of delaying their report of injury until they could pass a drug test. If the injured worker reports the accident and injury promptly, and pushes to get treatment quickly, the employer will not be able to accuse the injured worker of purposeful delay. Not all employers require a drug test, but if requested it makes a lot of sense to avoid suspicion from the insurance company. Plus, you do not want the insurance company to wait a couple of weeks, after a long holiday weekend or after the medical provider prescribes medication, to take a test for the first time.
- Do the recorded statement: Perhaps the number one tactic insurance companies employ to investigate a claim is the recorded statement. This is when the insurance company calls the injured worker on the phone to ask questions about the circumstances of the injury. State law allows insurance companies to deny claims where they were unable to complete an investigation. Injured workers that refuse to participate in a recorded statement give insurance companies an easy excuse to deny claims. At the same time, injured works should know that those recorded statements often include questions that the insurance company already knows the answer to. Insurance companies speak to each other about claims they have paid. If they ask you whether you have been in a car accident it is because they know you have been and they hope you lie.
- Get statements from witnesses: Just like everyone else, witnesses to an accidents tend to forget what happened. The best thing to do is ask the co-workers who saw what happened to send the injured worker a text or email about details of what they saw. Having the witnesses send these statements before their memory fades, and before the employer’s management put pressure on the witnesses, is usually the best for an injured workers’ claim.
- Take pictures: To an insurance company, the injuries that workers suffer are almost always not that bad. To demonstrate the severity of an injury later, injured workers should take pictures of the burns, scarring, cuts, and bruising they suffer after an injury. We can all disagree about the severity of swelling and bruising, but pictures help tell the story better than someone’s memory.
- File a North Carolina Industrial Commission Form 18: It is the injured worker’s responsibility to report their workplace accident to the Industrial Commission within 30 days of their injury. The method to do this is with a Form 18. The Form 18 asks for the date and place of the injury along with a brief description of what happened. Even though the injured worker has 30 days to complete the Form 18, it makes the most sense to get one of these filed as soon as possible. There are several reasons, but one of the most important is that insurance companies have their own deadlines to accept or deny cases once receiving notice of the injured worker’s claim. Why not prevent the insurance company from dragging their feet more than they already do?
