How Employers Try to Avoid Paying Workers’ Comp

Despite the civil liability protection they receive under the workers’ compensation system, many employers — or more often their insurers — seem willing to do anything it takes to minimize benefits or avoid payment altogether. Unfortunately in these cases, the burden often falls to you as the claimant to overcome these challenges before you can get the compensation you need to provide for your family while you recover.

Employers and insurers use several methods to minimize or evade workers’ compensation liability:

• Minimizing your injury — This is perhaps the most common argument comp insurers make, and it is especially easy with the help of their authorized treating doctors. Even when you have a provable injury that is clearly work-related, an insurer can try to minimize medical and wage loss benefits by declaring that you have reached maximum medical improvement and rushing you back to work before you are ready.

• Claiming it was preexisting — It is common for workers’ comp insurers to comb through years of medical records hoping to find any prior mention of a similar condition before the date of your current injury. A flare-up or aggravation of a preexisting injury is still compensable as long as your current work was a major contributing cause, but in cases where there is no traumatic accident to point to as the cause, an insurer may try to say you had the condition all along.

• Claiming it was not work-related — To be compensable, your injury must be sustained within the course and scope of your employment. While it is not unheard of for a person who is injured at home to try to say it happened at work, this type of fraud is exceedingly rare. Nevertheless, insurers use these isolated incidents as an excuse to doubt the truthfulness of every claimant.

Workers’ comp insurance carriers in Florida often deny even strong claims, so it is important not to lose hope just because you meet some initial resistance. When the carrier persists in denying you the benefits you deserve, a West Palm Beach workers’ compensation attorney can help you fight for a fair result.