Most of the time, when an employee says they got hurt on the job, they’re telling the truth. Other times, a worker exaggerates their injuries so they can stay out of work a little while longer. In cases like this, most employers are reasonable about approving their employees’ claims. After all, it’s not as if the money is coming out of your employer’s pocket. It’s being paid by their insurance company. However, the more money the insurance carrier has to pay out, the higher the company’s premiums. This is why many employers are getting very strict about approving workers compensation claims. Our Cincinnati workers comp lawyers are meeting with a lot of clients who, on the surface, had valid claims. Yet their claims were denied. And not only were they denied, but they were rejected due to suspected fraud or exaggeration.
If this has happened to you, then it’s time you contact our office. Sit down with one of our workers compensation attorneys in Ohio. They can review your claim and find out what about your situation caused your employer to think your claim was fraudulent. Here, we’ll discuss the 5 biggest things that make your employer think you’re faking your workers compensation injuries.
You Report Your Injury on a Monday
One of the biggest red flags when it comes to fraudulent workers comp claims is getting hurt on a Monday. A lot of times, a person gets hurt over the weekend but tries to make it appear as if they got hurt at work. They figure, since their injury is fresh, the state-approved workers compensation doctor won’t be able to tell that the injury was sustained just the day before. Your workers compensation attorney in Ohio will have to find a way to proof that your injuries were actually sustained on the job.
You Have a Poor Attendance History
It’s no coincidence that someone with poor attendance would report a workplace accident. Like it or not, there are a lot of people who would do almost anything to get out of having to work. The idea that they would be paid for this time off is too tempting. They decide to fake a workplace injury (or at least exaggerate it.) Their hope is that their employer will either feel bad about their attendance issues now that they’re hurt or that they’ll forget about it all together. Since neither of these things are bound to happen, your Cincinnati workers comp lawyer will have their work cut out for them. If you truly have a horrible attendance record, it will be hard to convince the insurance company that your claim is legitimate.
You Have a Lengthy Disciplinary Record and Are on Your Final Written Warning
Sometimes, when a person knows they’re about to be fired, they fake a workplace injury. They figure they can buy a few months (or even a year) by pretending they were hurt. Employers have been fooled so many times over the years they have become suspicious of their employees. If an employee is on probation, it seems rather convenient that they would suddenly suffer a workplace injury. Your employer would rather be safe than sorry. Once they approve your workers compensation claim, it can be hard to terminate their benefits. They would have to definitively prove that you were faking your injury. This can be very difficult. It can also be very expensive for the insurance carrier to investigate such an accusation.
You Have a History of Filing Workers Compensation Claims
As soon as your employer submit your claim to their insurance carrier, they’re going to have access to your workers compensation history. If the insurance adjuster sees that you have a pattern of filing workers compensation claims every couple of years, it’s going to cast doubt on your current claim.
You can understand why it would look fishy if you file a workers comp claim at every company you have worked for. If your employer has a feeling you’re lying about your accident or injuries, they will deny your claim. At this point, the burden will shift to your workers compensation attorney in Ohio to prove your claim is real.
Your Workers Compensation Attorney in Ohio Will Have to Prove that Your Claim is Legitimate
It may seem unfair, but your workers compensation attorney in Ohio is going to have to somehow prove that your claim is legitimate. You would think it would be the other way around. However, since workers comp benefits are a right and not an entitlement, you may have to demonstrate that you qualify.
In order to qualify for workers compensation benefits in Ohio, you must show the following:
- You were hurt in a workplace accident
- The accident happened on company property and on company time
- You weren’t under the influence of drugs or alcohol at the time of your workplace accident
- You reported your accident to management or Human Resources immediately
- You agree to be treated by a state-approved workers comp doctor
- You don’t work a second job while collecting benefits
- You participate in your medical treatment
As long as you meet these criteria, your Cincinnati workers comp lawyer should be able to prove your case.
Don’t Waste Time – Contact a Skilled Cincinnati Workers Comp Lawyer Now
You only have a certain amount of time to appeal your workers compensation claim. The statute of limitations for workers compensation in Ohio is two years. The two years starts on the date of your workplace accident. The court isn’t going to be forgiving just because it took five or six months for your workers comp appeal to be resolved. This is why we recommend that you hire an experienced workers compensation attorney in Ohio as soon as possible after your injury. This way, your Cincinnati workers comp lawyer has plenty of time to prepare your case. The last thing you want to do is wait until the last minute to talk to a lawyer. If they don’t feel they have enough time to properly review and prepare your case, they won’t be able to represent you.
Since we offer all new clients a free, initial consultation, there really is no reason to wait. Even if you wait a few weeks to decide whether you want to retain our services, you want to at least get the ball rolling. Just contact our office and set up a date and time to come into the office. Sit down with one of our Cincinnati workers comp lawyers right away and ask them any questions you may have. Since the consultation is free, you pay nothing upfront.