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5 Misconceptions About Workers' Compensation

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Approximately 90% of job-related injuries are first time occurrences, which means if you have never been injured on the job you may have several misconceptions about how the workers’ compensation system works.

Not fully understanding the workings of workers’ comp isn’t uncommon, but if you’ve been injured on the job its your responsibility to learn more about the system. Dispelling these misconceptions and understanding your rights as an injured worker will only help you in your injury recovery.

Before you begin your journey to better health, overcome these 5 misconceptions about workers’ compensation.  

1. As an injured worker, I’ll be viewed as a fraud.

Unfortunately, injured workers are often seen as malingerers, trying to defraud the workers’ comp system and their employer out of money and resources. However, studies show that only 1-2% of workers’ compensation claims are fraudulent.

In fact, employer fraud is far more likely than employee fraud. This happens when employers under report payroll or misclassify their workers in order to pay a lesser premium for coverage. This type of fraud has cost the state’s workers’ comp systems millions of dollars, yet injured workers are the side that become classified as “frauds”.

2. My employer is in charge of my medical care. 

Not always. Each state has its own set of rules and guidelines in place within their workers’ comp system. In some states, like Florida, you must treat with a doctor that has been approved by your workers’ comp insurance carrier, who was hired by your employer. But, in other states, unless noted within their statute, you may have the ability to select the doctor of your choice.

When your employer hires an insurance carrier for workers’ comp coverage, they organize the review, approval and denial of your treatment – including medication, surgery and DME products. Although the insurance carrier has a team in place to make medical decisions, that doesn’t mean that those decisions are binding. By working with an attorney, they help fight to get you the treatment that you deserve under workers’ comp.

3. Only physical injuries can be covered under workers’ comp.

Broken bones, sprains and strains are typical types of workers’ comp injuries, but the term “injury” has gone far beyond physical ailments since the workers’ comp system was created. Recently, mass tragedies such as Sandy Hook School Shooting and the Pulse Night Club Attack have made way for adding mental health claim coverage to workers’ comp. Workers suffering from PTSD, anxiety and depression are now slowly but surely gaining access to the benefits and treatment they need in order to return to better health.

4. If my employer denies my workers’ comp claim I’m out of luck.

After filing a workers’ comp claim, your employer does have the ability to deny your claim if they believe the injury did not happen on the job or that the injury was a result of a violation of company policy. This may happen if the injured worker was under the influence of drugs or alcohol or the injury happened outside of work hours.

If your workers’ comp claim has been denied it can feel devastating. The good news is that there are advocates available to help you during that difficult time. Law firms specializing in workers’ comp law are available to help file appeals on your behalf. They will not only fight for your wages but can take up issue on any account – including pharmacy bills and medical visit approvals.

This is also where Injured Workers Pharmacy specializes. If your workers’ comp claim has been denied, retail or other local pharmacies, typically will not fill your medication or will ask that you pay out of pocket. When you’re out of work and dealing with costly medications, sometimes it’s just not possible to get your prescription filled. IWP will work with you and your attorney to provide you with your workers’ comp medications throughout litigation – eliminating delays in your recovery.

5. My employer doesn’t want me to get better.

It might feel like your employer is rooting against you, but it’s actually more costly for them when a worker is out for an extended period of time. Recently, Return to Work Programs have been popping up within companies as a way to help employers save on workers’ compensation costs by allowing the injured worker to slowly transition back into the workforce. These programs offer injured workers a more flexible schedule, reasonable accommodations to make the job less physically demanding and an opportunity to get back into the workforce at your own pace.

Related: Why Can't I Fill My Prescription?

These five misconceptions are just the tip of the iceberg within workers’ compensation. If you’ve been injured on the job, be sure to educate yourself on these important items so that you never go without the benefits you deserve.