Understanding Workers' Comp Delays and How an Attorney Can Help

By Staff Reporter Jan 05, 2022 11:15 AM EST

Workers' compensation provides benefits to eligible workers injured on the job to cover lost wages and medical expenses. However, applying for and receiving the benefits you deserve is often frustrating, with long waits and delays that may prevent you from covering day-to-day living costs.

Usually, hiring workers' compensation lawyers will help you with your situation and take some of the burden of this situation off your shoulders. Knowing some of the common causes of delays and how to handle an undervalued claim are things an attorney can help with. Keep reading to learn more.

Common Delays in Workers' Comp Claims

While workers' comp claimants are supposed to receive the benefits they deserve quickly, delays often occur. Some of the most common causes of these include:

Delays From the Insurance Company

The insurance company may cause delays to some claims. Understaffing, administrative errors, or poor staff training may cause this. Sometimes, delays are caused by the insurer working to negotiate a lower settlement for your claim.

Delays From Your Employer

If your employer doesn't follow the proper reporting or filing process, delays can occur. They may also try to discredit or ignore your claim to avoid having to pay benefits. This is often done to help keep their insurance costs down.

Errors With Your Claim Paperwork

Mistakes or omissions in your paperwork may cause delays. The insurance company will request that you re-submit some forms to provide the needed details in most cases. Having an attorney help fill out all paperwork can prevent these types of delays in many cases.

How to Handle an Undervalued Workers' Comp Claim

Workers' compensation cases aren't always black and white. You may receive an unfavorable settlement offer or even have your claim denied. While this can be frustrating, you have a few options.

For example, you can appeal the decision. While this is possible, you must act quickly.

If you receive a letter from the insurance company that your claim has been denied, it should also contain information about how to appeal the decision. Usually, you have 60 days from when the letter is received to request a hearing before an Administrative Law Judge (ALJ). The ALJ will likely set a hearing to occur within 90 days of the request. Decisions are typically issued within 30 days of the hearing.

Sometimes, you won't agree with the decision made by the ALJ. If this happens, you can appeal their decision to the Workers' Compensation Board. You usually have 30 days to issue this appeal.

If you are still unsatisfied with the decision made at this point, a workers' compensation attorney can help you take the case to court.

Is an Attorney Necessary to Settle Your Workers' Compensation Claim?

Not all workers' compensation cases require legal expertise. However, there are some situations when it is helpful. Usually, when complexities arise in your case, you need an attorney. Some examples of when legal representation is needed include:

An employer denies your claim or doesn't pay the benefits promptly
The settlement offer doesn't cover all your medical bills or lost wages
You experience medical issues that keep you from going back to work, keep you from ever going back to work, or limit your abilities on the job
You plan to apply for Social Security benefits
Your boss retaliates against you for filing a workers' comp claim
Your injury occurred due to the actions of a third party or misconduct of your employer