How To Handle a Dispute Over the Cause of Your Work Injury?
If you have suffered an injury on the job, you expect your employer and their insurance company to approve your workers’ compensation claim quickly so you can receive the benefits you are entitled to. However, the reality is that sometimes, disputes can arise after a worker files a workers’ compensation claim that causes delays, unnecessary stress, and sometimes even a denial. Among the many disagreements that can arise during the workers’ compensation claims process are disputes regarding the cause of your injury. Knowing how to respond and what to do when disputes over the cause of your work injury arise is vital for keeping your claim on track and protecting your right to compensation.
Why Do Employers and Insurers Dispute Work Injury Causes?
The following are some of the main reasons your employer or their workers’ compensation insurer may deny the cause of your injury;
- They may believe your injury happened outside the course and scope of your employment
- They may believe that the injury resulted from misconduct
- They may claim that the injury was self-inflicted
- They may argue that the injury is a pre-existing condition and not a new work-related injury
- You don’t have enough documentation or witnesses to support your version of events
- You delayed reporting your injury, thus raising doubts
Sometimes, an employer or the insurance company may be justified in disputing the cause of an employee’s injury. For example, if you have insufficient evidence. However, disputes are often a tactic to delay or deny a worker’s claim.
Handling a Dispute Over the Cause of Your Injury
If your employer or their workers’ compensation insurer is disputing how your injury happened, take the following steps;
- Review the Reason(s) for the Dispute
The first step should be to review your employer’s or the insurance company’s explanation. If your claim is denied, review the denial letter. You want to first understand why there is a dispute over the cause of your injury or why your claim has been rejected. After you know the specific problem, you can respond effectively and collect the right evidence.
- Gather and Organize Evidence
Once you understand why there is an issue, gather and organize all relevant documents that can help you prove your injury is work-related. This includes medical records, witness statements, photos, and video footage. Ensure your medical records clearly indicate that you suffered your injury because of your job.
- Request a Second Opinion
If you are sent to a doctor who claims that your injury is not work-related, consider seeking an independent medical evaluation (IME) or a second opinion. The good news is that in Vermont, workers’ compensation pays for a second opinion as long as it is reasonable and necessary.
- File a Claim With the State (If Necessary)
If your claim is delayed or denied, you can file a formal complaint with Vermont’s Department of Labor. Depending on the circumstances of your case, the DOL can help resolve the issue through mediation or a formal hearing.
- Hire a Workers’ Compensation Lawyer
Dealing with a disputed claim can be complex and stressful. A skilled workers’ compensation lawyer can gather evidence, challenge unfair delays and denials, represent you at hearings, and ensure all deadlines are met and procedures are followed.
Contact Us for Legal Help
Injured at work and facing a claim dispute? Contact our skilled Vermont workers’ comp lawyer at Sluka Law PLC at 802-457-1000 or online for legal help.
Source:
lawinsider.com/dictionary/course-and-scope-of-employment
