The construction industry is inherently risky, and workers frequently face hazards that can lead to severe injuries. Whether they sustain an injury at Public Square in Downtown Cleveland or in an outer suburb like Parma, construction workers find that they need to file for workers’ compensation to cover medical expenses and lost wages. Unfortunately, this process is not always straightforward.
Eligibility is always a concern
Before filing for workers’ compensation, construction workers must understand if they are eligible. Not all injuries are covered and must meet specific requirements. For example, the injury must occur while performing job-related duties. The worker must also report the injury to their employer within one year. They also need medical documentation to support the claim. They can get this from a doctor of their choice, but the doctor must be BWC-certified (Bureau of Workers’ Compensation).
Delayed or denied claims can happen
Workers’ compensation claims can be rejected or delayed for various reasons. Understanding these common issues can help claimants better navigate the process and avoid potential pitfalls. Here are some of the most frequent reasons:
- Incomplete or inaccurate paperwork: Construction workers often work with their hands and may find that the piles of paperwork are challenging. They may lack proper documentation, fill it out inaccurately or omit important information.
- Disputed injury: Employers or insurance companies may believe the injury did not occur at work or that it was not as severe as claimed.
- Insufficient medical documentation: Issues can arise if the medical records are incomplete, the injury is not clearly linked to the workplace incident, or lacks supporting evidence.
- Pre-existing conditions: Construction work is dangerous and hard on the body, so insurers may deny claims if it believes the injury is related to a pre-existing condition or previous claim.
- Non-compliance with treatment: The worker must follow the prescribed medical treatment plan and attend medical appointments.
- Lack of witnesses: Witnesses to injury strengthens a claim, and no witnesses can weaken it.
- Employer errors: Employers may not submit necessary documentation to the insurance company or groundlessly dispute the claim.
Help is available
Understanding these common reasons for workers’ compensation claim rejections or delays can help employees take proactive steps to avoid them. Still, it may not be enough. Working with a law firm that helps employees navigate this complex process, whether it is filing the initial claim or appealing a claim denial, can provide peace of mind to the injured worker.