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How to be the perfect workers' comp client

How to be the Perfect Workers’ Comp Client

Episode 22: Louisville workers’ compensation attorney Scott Scheynost has represented injured workers for almost 35 years.  There are things a client can do to help or to hurt his/her workers’ comp claim.  In today’s episode, Scott provides tips to explain how you can be the perfect workers’ comp client.

Notify Your Employer of Your Injury

Under Kentucky law, if you’re injured at work, you are required to inform your employer.  Telling a co-worker doesn’t satisfy the rule.  You should tell a supervisor, manager or someone “higher up the food chain.”

You aren’t required to immediately tell the employer.  For instance, if you’re unconscious, it would be impossible.  If you’re taken away in an ambulance, this may happen before you’ve communicated with your supervisor, although Scott admits the employer should be aware that an ambulance was onsite and who was transported to the hospital.

The risk can occur when an employee is injured, but thinks he/she can work through it and will be better the next day.  If the employee returns to work and later decides they need to seek medical treatment, notice should be given to the employer at that time. 

It’s also a good idea to document when you told the employer.  You may need this provide this later, if the employer claims you never told them about the injury.  It’s also a good idea to document any witnesses who were there at the time of the injury.  They may need to be called as witnesses, later.

How to be the perfect workers' comp client

Choose Your Own Doctor

Scott explains that you have an important right to choose your own doctor, under Kentucky law.  This is extremely important.  You are not required to see the doctor your employer recommends.  If you have to see them, you still have the option of choosing a different doctor.  Your doctor will normally have your best interest at heart. 

There are situations in which the doctor your company wants you to see may make decisions more favorable to your company, such as minimizing the extent of your injuries or telling you to return to work before you’re actually ready.  Both actions could easily limit the financial exposure the employer and the workers’ comp policy has to pay.  You also risk not receiving the workers’ compensation benefits you deserve.

Scott explains that you only have 2 chances to pick a doctor.  There’s a chance you may need to change doctors, but you can’t keep doing it.  In fact, if you complete a certain form (or simply sign the paper) it may stipulate that you’re selecting this doctor to treat you – even if it’s the company doctor you don’t want to pick in the first place.  You need to be careful of the games your employer may try to play.  This is one reason having an experienced workers’ compensation attorney on your side is so important.

Be Specific when Talking to Your Doctor

Scott recommends that you ensure your doctor understands your injury happened at work.  You want them to document that fact in the medical records.  The other side will do what’s possible to try to disqualify you from getting your benefits.  You need to ensure you tell the nurses and doctors that this injury is work-related.

If the doctor has to testify in your case, or in a deposition, he/she may not remember your specific case.  They’ll always refer back to what they noted when you went to see him/her.  It’s vitally important that they know what happened, where it happened and where your feeling pain as a result of the injury.

Follow Your Doctor’s Orders

You need to do everything possible to follow your doctor’s orders.  If you are referred to physical therapy, you need to go.  If they recommend other types of treatment, follow their directions.  When you ignore the prescribed treatment, it gives the insurance an opportunity to argue your injury must not have been that bad.  After all, you didn’t even complete your medical treatment.

The judge and the doctor handling your case are more likely to help you, if you demonstrate that you’re trying to help yourself.

Hire an Attorney

You don’t need to do this immediately, but the earlier you do this, the better.  This is especially true if your injury is serious.  Most workers’ compensation attorneys offer free consultations and work on a contingency fee basis.  They’ll only get paid if they win your case. 

You want to make sure your claim is built on a good foundation and that you don’t give up benefits you should be receiving.

Know Specific Information Related to Your Claim

Scott reminds us that the medical provider will normally send the invoices to the insurance carrier.  This is why you want to know your claim number and provide it to any medical provider, including physical therapist and pharmacies you visit.  You’ll also want to give them the name of the insurance carrier and even the name of the adjuster.  You can easily keep this information on a slip of paper in your wallet or purse.  You could add it to your cell phone contacts. You might even just send yourself a text with this information.  Whatever is the easiest to help you remember the information, do it.

Submit Your Expenses as Quickly as Possible

From time to time, you may end up paying something that should be covered by your workers’ compensation benefits.  This could be a mileage expense or something else.  Scott explains that a new Kentucky law requires that the expenses must be submitted within 45 days. 

You’ll need to use the FORM 114 Request for Payment for Services or Reimbursement for Compensable Expenses.  You can print a copy of the expense reimbursement form by clicking the above link.

You should always keep a copy and record the date you submitted it.  The forms often get lost.  Having a copy makes it easy to resubmit the completed form.  At the same time, documenting each time you submit it can be helpful if they dispute the 45-day rule.

Be Careful When Posting to Social Media

The insurance adjuster is going look for ways to avoid paying benefits.  If you post something on social media, or someone else does, it can provide proof to support their claim.  If you’re claiming an injury is preventing you from doing something, but then post a picture of you doing it or something similar, you’re making it difficult for your attorney.  It’s better to limit what you post and avoid posting anything related to your injury, treatment or recovery status.

Let Your Attorney Speak for You

The workers’ compensation system can be frustrating.  It takes a long time.  It’s complex.  You’re dealing with people who aren’t moving as quickly as you’d like.  It’s best to let your attorney speak on your behalf.  The claims adjuster you want to go off on is probably the one you’re stuck with for the next several years.  Don’t cause trouble for them.  It’s best to let your attorney handle issues that arise.  They’re used to dealing with adjusters and know how far and how hard to push, without harming your cases.

Be Responsive to Your Attorney’s Request

While the workers’ compensation process is slow, when things happen or deadlines approach, your attorney may need information from you.  When your attorney calls, emails or sends you a letter, it’s for a specific reason.  Responding promptly may help to move your case forward.  After all, you want to be the perfect workers’ comp client, right?

You might receive forms that need your signature or additional information.  When you receive these from your attorney, it’s extremely helpful when you get them back to your attorney in a timely manner. 

Have Patience with the Process

Scott admits that the workers’ comp process can be frustrating.  Many clients don’t realize how important it is to reach maximum medical improvement before your case can be resolved.  If you have ongoing medical treatment and/or surgeries, we won’t know the extent of your impairment rating or the amount of medical expenses you’ll incur.  These are important factors in determining the full value of your claim and what your workers’ comp benefit payments should be.

The impact of the pandemic has also caused the system to move more slowly.  Patience is going to be required, but it will usually be to your benefit.

Once the information is available, it’s time to try to settle your claim.  If a fair resolution can’t be reached, litigation may be required.  Unfortunately, preparing for trial and going through this process will add more time to the process.  Again, it can be frustrating, but it will eventually get resolved.

Remember, while this is all playing out, it’s important that you do everything possible to follow your doctor’s orders.  The judge will consider this when making important decisions related to your case.  People want to help those who are trying to help themselves.  It’s just human nature.

It Cost You Nothing to Speak with Scott

Contact Scott Scheynost at (502) 937-5287.  This podcast is meant to provide information and is not legal advice.  Scott’s principal office is located at 7619 Dixie Highway, Louisville, KY 40258.  Co-host Jim Ray is a non-attorney spokesperson.  This is an advertisement.