How workcover insurances use fraud accusations to rob injured workers

“News Tips” kindly sourced this very interesting article on The personal injury Law Journal  about how the insurance industry uses the threat of fraud accusations as a way of keeping injured workers from pursuing their rights…

WorkCover fraud

How the [workcover] Insurance Industry Uses Fraud Accusations as a way of Keeping Injured Workers from Pursuing Their Rights

The author of this article, A. Kravitz, writes that those who work in the workers’ compensation practice are in a unique system that has tried as best it can to separate fact from fiction, the reality from the perception, mostly in order to do the right thing when it comes to awarding benefits to injured workers.

Kravits further states that he has seen that more and more often, their search for the truth and desire to do the right thing has taken a back seat to the search for the gotcha moment: every omission an injured worker makes to a doctor is treated as a fraud; every task a worker completes out of necessity that he or she states he cannot do is a lie. He rightly says that the casualness of these fraud accusations is a growing virus that will pulverize the practice and jeopardize the efficient administration of the Workers’ Compensation Court.

According to the author, an injured worker can nowadays actually be whipsawed into saying or swearing to almost anything.

In one recent, true case, Kravits  represented a client who suffered a re-injury at work at work and reported it appropriately to his boss. His boss told him that they will send him to a doctor, but if the doctor says he cannot work, they will have to fire him. They asked him if that’s what he wanted and the worker said no and refused to go to the doctor. The employer then told him that if he didn’t go to the doctor, he would be fired unless he chose to resign in order to collect unemployment. The client filed for unemployment and, after he resigned, he contacted [Kravitz] asking for a doctor and wanting to apply for disability.

Interestingly, Kravitz states that:

If this man applies for Social Security, does the fact that he told unemployment he was capable of working prevent him from collecting Social Security? No, but, that fact will be used against him at a Social Security hearing.”

These issues don’t even touch upon people who suffer from major depression after an accident, he says, which in and of itself can contribute to the debilitating process and make an injury even worse.

And so Kravitz concludes that “once we fall into making assumptions that every worker is trying to gain the system, therefore, every worker is suspect and as such every inconsistency by an injured worker is treated in the harshest possible way”.

The legislature clearly did not intend for this to happen.

 

[Source: Posted by Arthur H. Kravitz on December 16, 2011 on Personal Injury Law Journal ]

Sourced by “News Tip” with thanks ;)

About WorkcoverVictim

I was assaulted by a large patient whilst working as a nurse . I underwent numerous major shoulder reconstructions and suffered near fatal complications. I am left with an extremely painful and irreparable dominant arm. This site was born out of my sheer frustration, anger and grief regarding the workcover system where all is not made clear, where the waters are very murky, and when the chips are down, the very people who are responsible for duty of care and support simply choose to ignore you, the injured worker. I dedicate this site to all injured workers who have been abused by the adversarial workcover compensation system. May they never give up, may they fight like warriors for their legitimate rights, and -most importantly- may they hold onto their dignity, self-respect, self-esteem and sanity; and may they WIN!

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