How Are Workers’ Compensation Claims Benefits Calculated?

Workers’ compensation decision cases are based on your lost ability to work. Not on your personal injuries or the amount of pain and suffering endured. Instead, they only consider lost ability to work. That’s another area that makes workers’ compensation very different from personal injury cases in which pain and suffering or loss of enjoyment of life are factors that are weighed and considered. You could very well be in a harrowing situation, but you’re unfortunately not going to be compensated for your pain and suffering. You will only be reimbursed for how the accident impacts your ability to work presently and in the future. Thus, the compensation you’re entitled to would be for temporary disability. It’s going to provide you with 2/3rds of your regular pay. The workers’ compensation insurance will also cover your medical care.

What Are Some Common Reasons That Workers’ Compensation Claims Are Denied Or Disputed?

There are various common reasons for denying a claim. They include that you were not injured at work, your injury is pre-existing, or you didn’t notify the employer that you were injured in a timely manner.

An additional reason for denial is the assertion that your misfortune does not meet the definition of a genuine accident. For example, suppose you’re doing typical work at your job. Nothing different happens from the norm, yet you suddenly experience pain. In that case, it may be very difficult to prove the injury was work-related.

What Are Some Delay Tactics That The Insurance Companies May Use To Delay The Workers’ Comp Claim?

It can be very challenging to get approvals for specialists or alternative care providers. You may require an orthopedic doctor but are stuck with a general physician since insurance companies control medical care. There’s also the matter of whether the employer offered you to return to work and what restrictions you may have. Sometimes, work restrictions may hinder someone’s ability to return to work, even when they need to. Then if you return to the job, the insurance company may still try to deny benefits to you, likely saying you’re not compliant with the doctor’s orders.

Insurance companies will make it challenging for you to return to work after an injury. Your professional relationship with your employer may be blemished after filing a workers’ compensation claim. Your employer likely won’t feel good that you filed a workers’ compensation claim, and you probably don’t want to be a workers’ comp employee. Thus, it’s clear how it could be challenging to return to the same work environment and feel comfortable.

Also, insurance adjusters can be notoriously difficult to reach. You could find yourself calling three or four times over a week and maybe get the insurance adjuster on the phone one time.

These are all reasons why having an attorney to help you can be accommodating. We can ensure that the work restrictions you’re getting are fair and are fully prepared to file and fight for your claim.

For more information on Workers’ Compensation Law In North Carolina, a free initial consultation is your next best step. Get the information and legal answers you seek by calling (919) 999-4462 today.