What makes a 'bad' workers' compensation claim?

From your perspective, any workers' compensation claim you have to file is a "bad" claim -- because that means that you're injured, hurting and unable to work. You may just feel lucky that your accident happened on the job -- and is, therefore, covered under the workers' comp system.

Your company's insurer, however, likely has a very different idea of a bad claim. By that, they're looking for signs that a claim is somehow false or designed to "cheat the system." The only problem is that it doesn't take much for an insurance company to decide that a claim is so bad that it outright stinks.

What do insurance companies consider to be the signs of a bad claim? Consider these insights offered by insurance company professionals:

  1. You've been injured before, especially if you have a history of spinal injuries. Your employer may claim your new injuries happened while you were mowing the lawn or cleaning your house, not at work.
  2. You get injured early on a new job. Whether it's your first day or your first week, you can bet that the insurance company will view you with suspicion -- even though your lack of experience or safety training probably led to the accident.
  3. You have the nerve to ask about your benefits shortly after your injury. According to insurance companies, you couldn't possibly just be anxious and trying to figure out your rights.
  4. You pick a doctor that treats patients with sympathy. That's called a "pro-plaintiff" doctor in insurance parlance.
  5. You're close to retirement. The insurance company may basically decide you're trying to take an early exit and dragging along an injury claim to do it.

Now, none of these are fair. Being new, close to retirement or asking about your benefits doesn't make your work injury claim invalid -- but that isn't what the insurance companies tell each other. If you feel like your work accident claim has been received with hostility, it may be time to learn more about your legal rights.

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