If you sustain an on-the-job injury, you should qualify to submit a claim for workers’ compensation benefits.
However, considering that this line of insurance is highly regulated, you may hesitate to file a claim on your own, even if your injury is a minor one.
Part of a bureaucracy
Workers’ compensation is a type of highly regulated insurance, and regulators actively pursue fines and penalties associated with both claim forms and payments made. In fact, regulators can automate fines and penalties through their electronic data interchange capabilities. The costs associated with the complicated network of regulations are significant. The money collected as the result of fines and penalties goes mostly to the states and not to injured workers.
Trouble with definitions
To make the issue of benefits more complicated, concerns continue to develop as to the definition of an employer-employee relationship, or what constitutes an employee as opposed to an independent contractor. In 2015, a memorandum from the Department of Labor provided the interpretation that “most workers classified as independent contractors are employees under the Fair Labor Standards Act’s broad definitions.” This is one of those areas where an injured worker may need help to determine his or her workers’ compensation eligibility.
Undervaluing your injury
Another area of concern for workers is the matter of undervaluing an injury. You may be anxious to receive financial compensation because you are unable to work and face some large medical bills that you can ill afford to pay. The insurance company is not above taking advantage of your pressing need by offering a minimal settlement. The workers’ compensation insurance company may also deny your claim, saying that elements or conditions outside of the workplace were responsible for your injury. These are among the reasons to consider help from an advocate when the time comes to file a claim. You need only look as far as the tight regulations on workers’ compensation insurers to understand why they need to keep as much money as possible instead of providing you with the financial benefits that you deserve.