After an on-the-job injury, you may have filed for workers’ compensation (WC) benefits. However, if you are waiting for the checks to arrive and there seems to be a delay, there may be a reason for it, and we can help.
Often insurance companies want to avoid paying out benefits, and one of the ways they do this is to delay payments and hope the injured worker doesn’t press the issue.
The Purpose of Workers’ Compensation
Most employers are required to carry workers’ compensation insurance. When an employee is injured on the job, the employer must file a claim with the insurance company to help get the employee benefits.
Workers’ compensation benefits typically cover medical bills related to the accident, treatment after the injury, and lost wages. The wages are usually only a percentage of the employee’s regular pay, but they can significantly help them meet their financial needs during recovery.
If the injury is severe and the employee suffers permanent disfigurement or loss of body function, they may receive long-term permanent benefits such as lost wages and ongoing rehabilitation treatment.
State laws regarding workers’ compensation vary slightly from location to location.
Some Reasons Your Workers’ Compensation Checks May be Delayed
Although your checks may be delayed as a stall tactic, there could be a variety of other reasons you aren’t getting them. Some of the most common reasons you might not be receiving your benefits are:
If you or your employer mistakenly labeled your injury a “non-injury,” the WC insurance company will not process any benefits.
Injury Under Review
If the insurance company believes you are not truly injured, they may delay payments to perform a full investigation to determine if you are really hurt and cannot work. This process may take extra time and delay your checks for weeks.
Some WC companies want to pay the bare minimum, so they delay checks while they determine how much to pay and wait out the clock.
Some adjusters will ignore claims for a while, and even if your employer attempts to contact them to move things forward, they may become incommunicative. Their motives may be to miss deadlines, so the company doesn’t have to pay out your benefits.
If the company is shorthanded, they may claim processing delays. The company may claim they never received the proper documentation or the file lacks critical evidence. If you receive repeated requests for medical documents and other paperwork, this might be what is happening.
Denial of Benefits
Part of the workers’ compensation process is that the company must approve benefits and treatments. If the WC insurance company disputes your injury, they may deny your benefits altogether or not authorize payment of specific medical treatments that they deem unnecessary. For example, the company could claim the injury was self-inflicted or that you were under the influence of drugs or alcohol when the accident occurred. They might even argue that it was not a work-related accident or you were not on company property when you were hurt.
A denial of benefits could cause significant delays in getting your WC checks.
Light Duty Options
Your employer might offer you a light-duty position during your recovery. However, this could be a tactic to prove that you are not as injured as you claim to be. Therefore, be careful when accepting light-duty positions, which could affect your benefits.
What to Do if Your Workers’ Compensation Checks are Delayed
If you are worried about your checks and feel like they might be late, you don’t have to keep waiting. Follow the steps below to try to move things forward and get answers.
1 – Think About the Timeline
Understand that your checks won’t start arriving immediately after your injury. Typically, injured workers must wait a few weeks before they see the first check. Then they should keep arriving on the same day as your regular pay and on the same schedule.
2 – Talk to Your Insurance Adjuster
Try to contact the insurance adjuster in charge of your case. Ask them where they are in the process and when you should expect your checks to begin. They could shed some light on where the issue lies.
3 – Talk to Your Doctors
Speak to your WC physician and make sure their bills are being paid. If not, you should follow up with the workers’ compensation insurance company.
4 – File a Complaint
If you feel like your benefits are intentionally being delayed, you have the right to file a complaint with your state’s workers’ compensation office.
5 – Contact Your Workers’ Compensation Attorney for Help
These types of issues only add more frustration and stress to an already uncomfortable situation. You need to focus on your recovery and not chase down your benefits so you can pay your bills. If you are having trouble getting your WC checks, it might be time to contact your workers’ compensation attorney for help. They have experience working with these types of companies and have succeeded in getting them to pay the benefits on time and in full.
When You Should Contact an Attorney
If you have verified with your employer that they have done all they can to facilitate your claim, including filing the paperwork on time and communicating everything regarding your injury to the insurance company, and you are still not getting your checks, it’s time to contact an attorney.
Additionally, if the insurance company denies your claim or initiates an investigation, you should have an attorney by your side. Your lawyer can help gather evidence and prove your injury to help get the claim pushed through.
Insurance companies and employers often try to delay or deny claims to get out of paying for benefits. However, as an injured worker, you have the right to workers’ compensation, and experienced attorney Adam Baron can make sure your adjuster sends your check on time.