You got hurt on the job, so you filed your workers’ compensation claim exactly as instructed. Then you waited. When you finally hear something, you’re told that your claim is either under investigation or outright denied.
What happened? You may have been “red-flagged” because of circumstances beyond your control.
The myth of the “benefit train” has created problems for honest workers
Workers’ comp fraud does happen, but it’s far more likely to occur on the employer’s end. Just the same, insurance companies tend to focus on mitigating their losses by looking for workers who file shaky workers’ comp claims just looking to “ride a benefit train.”
Here are the signs that insurers use to determine that a claim may be fraudulent:
- You’re a seasonal worker who was injured close to the end of the season
- You’re a new employee who was injured shortly after starting
- You’ve had disagreements with your supervisor and are “disgruntled”
- You’ve missed some work recently in the past and have “problem” attendance
- You have known financial problems
- You waited several days or weeks before you reported the injury
- You got hurt on a Friday or a Monday
- You were alone when you were injured
- You weren’t alone when you were injured but you’re on friendly terms with the witnesses
- You and the witnesses can’t agree on exactly how your injury happened
- You can’t recall the exact circumstances of your injury
- You were injured outside your normal work location
- Your co-worker tells the boss they don’t believe you were injured at work
- You make too many calls about your claim and act “pushy”
- You have hobbies that are described as “physical”
It doesn’t take much to realize that many of those “red flags” are ridiculous. For example, new employees are more likely to get injured in their first days on the job than seasoned workers who know the risks of every machine they use or action they take. Similarly, it’s absurd that being too friendly with your co-workers could throw doubt on your claims.
When you’re facing trouble with your workers’ comp claim
Fighting the red tape caused by red flags in your workers’ comp claim is nothing to try to handle on your own. A Milwaukee attorney can help you get the benefits you deserve.
