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Eleven Things That Can Ruin Your Claim

  1. IME – The independent medical exam generally takes the form of a report produced by a doctor who sees you one time for the purpose of assessing your claim and answering questions. Independent medical examiners range from truly independent to totally biased. Be careful of independent medical exams. Most of them are set up by claims managers whose interests are different than yours. These claims managers are looking for opinions that either deny medical care or close your case. Many IME doctors are happy to oblige them. When somebody orders an independent medical exam in your case, watch out. See IME.
  2. Self-insured employer – If your employer is self-insured, watch out. Employers self insure to save money. The way they save money is to not pay it to injured workers. Their tactics include suppressing claims, harassing injured workers, not paying benefits, slashing benefits, delaying benefits, withholding file information, and doing unfair surveillance films.
  3. Not doing enough to get yourself a pension could ruin your claim and your financial situation for the rest of your life. If you will never work again because of your injury, you qualify for a pension. Many persons qualify; but few are chosen. Getting a pension requires tenacity, an understanding of the system, persistence, a helpful vocational counselor, a savy attending physician, the ability to articulate your position, faith, and the ability to wait them out while they try and starve you. Is it worth the effort? A typical PPD settlement can be worth between $2,000 and $20,000. Many pensions are worth over $500,000. It is worth the effort! If you qualify for a pension, do enough to get one. See PENSIONS.
  4. Letting a vocational rehabilitation counselor (VRC) decide your working future is a mistake. You wouldn’t go into a restaurant and let someone else decide what you eat. Likewise you shouldn’t let a VRC, without input from you, decide your working future. Get involved. Know the vocational rules. Help design your vocational plan. Get trained and get a good job.
  5. Getting on the wrong side of a Claims Manager – Claims managers have a lot of power over your claim. They are overworked. Don’t be rude or mean, or get on their bad side. Do cooperate as required, but be smart about it. Do give them information that will help your case. Make it easy for them to help you.
  6. Missing a deadline can ruin a claim. Every adverse order must be protested or appealed within 60 days. Vocational determinations must be disputed within 15 days. Injury claims must be filed within one year of the injury. Occupational disease cases should be filed within two years…Don’t miss an important deadline or it will ruin your claim and more than your day. Also don’t fail to understand the scope and impact of an order. For example, when a wage order sets your wages it often fails to include some very important items such as overtime, bonus, a second job, lost health care benefits, and the like. If you don’t protest or appeal, the wage order becomes final and you will be stuck with this low wage rate for many years, and if you get a pension, you will be stuck with it for a lifetime.
  7. Comparing your case to someone else’s – Comparing your case to someone else’s, and thinking you will get similar results, is a mistake. You probably have different injuries, different doctors, different claims, different claims managers, different reactions, and different needs. You will get different results. What you get will often be the result of your injuries and how much work you put into your case, and it will have little to do with somebody else’s case.
  8. Not getting good legal advice soon enough – Not being smart about legal advice can ruin your claim. Don’t hire a lawyer if you don’t need one. Do hire a lawyer if you do need one. If your case has big problems or you don’t know what to do – then talk to a lawyer. Most offer a free legal consultation so you can learn about your claim and figure out whether you need a lawyer. Do this early enough in your case to give the lawyer, if you do hire one, a chance to help you make smart moves. Lawyers are better at thinking and planning ahead than they are at cleaning up a mess you made because you waited too long. If you need an initial legal consultation to assess where you are at and what you can do, we’ll give you one – for free. CONTACT US.
  9. Choosing the wrong doctor – Choosing the wrong doctor can ruin your claim. Some doctors care and can really help. Some don’t. Let’s take the hypothetical example of Unlucky Joe and Smart Jerry. Unlucky Joe has a back injury and goes to see a doctor recommended by his employer. That doctor starts a claim, tells Unlucky Joe he’ll get better soon, gives him some drugs, and sends him back to work too soon, where unlucky Joe re-injures his back. That doctor’s report is later used to close the claim and cut off Unlucky Joe’s benefits. Smart Jerry knew enough to choose his own doctor and got a good one. That doctor recognized there might be a problem and ordered diagnostic tests to include an MRI. The MRI showed a major back problem. That doctor helped Smart Jerry get the medical care he needed and good result in his workers’ compensation case. Unlucky Joe, Smart Jerry could well have had exactly the same injury; but their choice of doctors made all the difference. See also MEDICAL CARE.
  10. Not understanding or recognizing that depression can ruin your claim. If you have a serious injury and are out of work, out of money, unable to function as you would like to, and are in the dark about your rights; then you are probably depressed. Most people don’t want to know that they are depressed, and won’t admit it even if they do know. Depression has a lot of symptoms, among them is a tendency to sit around and do little or nothing about your problems. Unrecognized and untreated depression can ruin your case because you sit around feeling sorry for yourself while they stick it to you.
  11. Doing nothing to help yourself can ruin your claim. The Department of Labor & Industries or the self insured employer have an army of people working to process and close your claim. In many cases they are trying to short change you. If you do little to help your case, then you will get very little. Stand up, speak up, and increase your chances of getting a good result. Action cures fear.

Contact Seattle, WA Workers’ Compensation attorney Chris Sharpe if you have questions about your claim.

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