Mistakes to Avoid in Your Worker's Comp Case

Mistakes you can’t afford to make in your case.

Making a mistake in your legal case can cost you thousands of dollars. Even worse, you may not realize you are making a mistake until it’s too late.

Consider this situation:

Let’s say you’ve been in a car accident. You go home that night and try to sleep despite the pain, worry, and restlessness that keeps you awake. In the morning, the phone rings and the friendly voice of an insurance adjuster greets you good morning and asks if you can answer a few questions. You sleepily agree and because you are groggy, still shaken up from the accident, and not fully aware of the situation, you give a statement that the adjuster records.


This is where devastating mistakes begin to happen.


Did you know that you are under no obligation to give any statement, recorded or not, to an insurance company? The at-fault insurance company does not want you to know that.


As an honest and injured person, you may see no harm in talking to an adjuster, After all, you have nothing to hide. What’s the harm in providing information, right? Besides, if your car was seriously damaged in the accident then you may be very eager to speak to an adjuster thinking that the sooner you speak to an them, the sooner they can help facilitate getting your car repaired or providing a rental car.


You might not have realized at the time, but you may have volunteered information that could have a detrimental impact on you. The conversation you had with the adjuster may have seemed harmless, but more likely than not, the adjuster was fishing for information to use against you later. The harm comes when things are taken out of context and blown out of proportion.


For instance, you may have said “I’m okay” when you really meant, “I’m in pain, but I’ll probably be alright.”

Statements like this can and will be used against you later by the insurance company. Your seemingly casual conversation with the insurance adjustor is anything but casual. Insurance companies are serious businesses, and insurance adjusters are professional, skilled questioners who will save that recording for later use.


Remember, you are not under any obligation to provide a recorded statement to the at-party's insurance company.


Signing a document without understanding can be another major mistake you can make after an accident. Of course, people who have been in accidents are usually very distressed. Their everyday lives have been disrupted, therefore, they may wish that the entire ordeal was over and done already. Several injured people want to cooperate with the at-fault insurance company because they don’t want to make anything a big deal. They also believe that the insurance company has their best interest.

Sometimes, an injured person will delay seeing a doctor, believing that a few days of rest will take care of the problem. While this may be true, the insurance company will use this as an opportunity to undermine your case if the injury gets worse. The company will claim that the person was not seriously injured because they took so long to get treatment. In addition to this problem, you may not be able to use no fault benefits if you don't go to the doctor within 14 days. Delay in a personal injury claim can cost you money. Avoid the risk and go to the doctor.

Workers Compensation

The first mistake likely made in a Workers’ Comp case is failing to notify your employer of the accident within 30 days. If you do not notify your employer, then the Workers’ Comp insurance company can deny the case entirely. The best way to ensure that official notice has been made is to have your employer submit a First Report of Injury or Illness report.


Another common mistake is made when an injured employee is dissatisfied with their medical care and asks for a different doctor or a second opinion. Asking for a second opinion can have very serious legal implications and actually worsen your medical and legal stance, especially if the new doctor has the same state of mind.


Another mistake occurs when the insurance company sends you to a get a second opinion that you did NOT ask for. They could be trying to obtain an opinion beneficial to themselves which has the unusual name of an "independent medical examination" (unusual because there is nothing "independent" about it).  

Normally they cannot obtain an independent medical evaluation unless there is some type of controversy about your care.


Anytime you are in a situation that involves a second opinion from another doctor, you should consult with a skilled lawyer.


The biggest mistake can be made when an adjuster offers to settle your case on a lump sum basis. Usually, you will have no idea if the amount offered to you is fair and reasonable under the circumstances.

If you accept a specific dollar amount for settlement, it can take over 60 days before you receive it.

This can cause a problem if you put off doctor’s appointments while you wait for the money to pay for those doctor’s appointments. Also, the insurance company might stop paying your wage loss on the basis that it is "included" in your settlement. Suddenly you are in a situation where you need medical treatment, have no money coming in, and a settlement process that is dragging on.


Can I settle my case without a lawyer?


There are several cases that do not require hiring a lawyer. As much as lawyers (including myself), like to think we are indispensable, there are many situations that people frequently handle without ever contacting a lawyer. Such as, property damage, rental car issues, and payment of bills. There is no question that in many situations it is important to converse with a lawyer, but sometimes the facts and circumstances do not warrant hiring one.

As a general rule, if you are not injured and there is a police report finding the other driver responsible for a motor vehicle accident, it is not always necessary to have a lawyer. Similarly, in slip and fall cases where injuries can be minor, having a lawyer may be unnecessary as well.  


What's a good settlement in an injury case?


A good settlement in an injury case is generally very case specific. A few common factors are important to consider. First, will the settlement pay your bills and your lost wages? Usually, people who are injured have no way to pay medical bills, especially if the injury prevents them from working. Therefore a settlement that gets your bills paid and your wage loss recovered is a good place to start. Amounts after lost wages and medical bills can vary depending on the circumstances. Non-economic losses such as pain and suffering, loss of enjoyment of life, and loss of consortium, are damages that are considered in conjunction with medical bills and lost wages and are directly attributable to the injuries sustained in the accident.


The definition of a good settlement is obviously subjective and can vary depending on the case. In some situations there is a lack of insurance coverage which could mean a larger settlement is impossible, despite the lawyer’s best efforts. When damages are great but the insurance coverage is minimal, just getting the bills paid with a little left over is a good settlement for the circumstances. Often the settlement of a personal injury case has as much to do with injuries, coverage and the relationship of the person's medical condition and the negligence of the defendant.  Factors such as the amount of bills and lost wages, along with the type of insurance, and the circumstances of the accident also play an important role in assessing whether a settlement is good.


We have had some situations where we thought a settlement that a client was getting while using another lawyer was inadequate, but within the range of the value for cases of a same type and similar circumstances. Unfortunately when that happens it is typically too late to change anything.


You must have a solid understanding of the settlement process in order to make an informed decision about your injury case. There are the people who just want a settlement and they don't care how they get it; however, these people usually end up with a smaller settlement than those who are a engaged in learning the in's, out's, pro's and con's of the injury system.