If (or better yet, when) you hire/engage a workers’ compensation lawyer, help them help you obtain full treatment and benefits for your injuries. In order to fully maximise the amount of benefits the injured worker ultimately receives, lawyers depend on their clients (YOU) to provide them with the information they need to fully represent your case. There are several things you can do to help your lawyer in this effort, including watching what you do and say!
How injured workers can help their lawyers
Lawyers’ main responsibility is to do everything they can to get you – the injured worker- the medical treatment and maximum amount of benefits prescribed under the law (incl. weekly pay, lumpsum, etc).
But in order to fully maximise the amount of benefits the injured worker ultimately receive, lawyers depend on their clients (YOU) to provide them with the information they need to fully represent your case. There are several things you can do to help your lawyer in this effort.
As you may know, insurance companies, corporations, government entities and others have staff carefully working on their side to try and decrease the amount of benefits you ultimately receive. That’s why it’s important you do the following to ensure your case is not derailed or that your benefits are not reduced.
How you can help your lawyer win your workcover case
The following suggestions are based on a lawyer’s years of experience representing injured workers.
When approaching your workcover case, keep the following in mind.
Document everything and have copies
Since insurers and companies have limited communication directly with you (certainly about medical information) they rely heavily on medical records to determine the amount of compensation you’re potentially owed. Therefore, your records need to be complete, accurate and available to your lawyer.
Do your part by making sure every injury, condition or medical problem connected with your case is included in your medical records. If they’re not, insurers will question if the condition is connected with your work injury.
Be sure you communicate all problems clearly to the doctor and provide detail on what your symptoms are and which body parts are affected. And be sure you clearly communicate with your doctor how your injuries are affecting your daily life – ability to work, sleep, perform daily chores at home, etc. and ensure this is included in your records.
This applies to treatments as well – insurers will only pay for treatment related to your claim. If it’s not recommended by a medical provider IN WRITING, it will most likely not be paid for. Every treatment connected with your injury must be carefully documented…that includes EVERYTHING (over-the-counter medications, slings, bandages, gym membership in connection with an ordered exercise program, massage therapy and more)
Your medical records need to reflect ALL recommended and performed treatments. If you have any gaps in your treatment, there needs to be a reason why. If you do have gaps in your treatment and they aren’t documented as to why, insurers will either assume you got injured again or are trying to “milk” the system.
Besides medical treatment, you also qualify to receive wage loss benefits (aka weekly pay) if you missed work because of your injury. If you do have to miss work because of your injuries, it needs to be clearly stated in your medical records that a doctor ordered you to rest or imposed restrictions preventing you from performing your regular job duties. Your employment records must reflect this as well.
Remember too that you may incur other expenses related to your injury. Workers’ compensation entitles you to be paid for ALL losses you incur. Your lawyer cannot seek compensation for something they don’t know about or find out about much later. Whatever the incurred costs (…including travel costs), maintain receipts and careful records of the expense so they can be sure you’re compensated for it.
Watch what you say and do
Apart from good documentation, you also need to be very careful about what you say and do. Things you say or are seen doing can affect the ultimate outcome of your workcover case, perhaps even derail it completely.
Watch what you say!
That’s one reason why you should never speak with anyone from an insurance company. Workcover case managers and investigators are trained to build a rapport with you and gain your trust. They’re not just being friendly but are likely trying to get you to say something that will allow them to challenge parts of your case or even the entire thing.
Always remember, no matter how nice an insurance case manager or investigator seems a big part of their job is to pay you the absolute minimum.
Continuing on this adversarial theme, you should only discuss medical issues with your doctors and healthcare providers.
Nothing looks worse to a judge and jury than a statement that reads “patient is stressed that she will not get a large settlement for her injuries.” Also, your doctor’s perception could affect the treatment you receive if they believe your only goal is to obtain a large recovery.
We totally understand the desire to discuss your situation with someone…it’s natural to want to talk about something that’s having such an impact on your life. But limit your conversations to close friends and family in the privacy of your home. Always be aware of where you are and who is around when discussing your case.
And whatever you do, never ever brag about your case or any settlement. If the other side finds out you’re bragging
about your case, it brings into question the legitimacy of your claim and whether your injuries are as severe as you make them out to be. If you go around saying certain things, a judge will begin questioning your motivations…which is what you don’t want of course.
Watch what you do!
Another way the other side may try and reduce your claim is surveillance. It’s in fact pretty common so you can be sure someone will be watching you at some point during your case.
Many medical conditions brought on by workplace injuries come and go. Some days will be better than others. Therefore, one day you may feel like going fishing or doing some gardening. On others, you will hardly feel like doing anything. If the insurance company gets footage of you doing these kinds of activities on your ‘good’ days, they will ask your doctor, a judge or jury to compare your medical file detailing the ‘bad’ days to whatever the surveillance footage shows.
You can try to explain the footage is showing you on one of your ‘good’ days but the damage will be done.
And don’t think surveillance is limited to private investigators. Co-workers, neighbours, doctors, your home help (cleaner, personal carer) and even friends can be asked to testify on your activities and their observations.
In the end, you are responsible for many aspects regarding your workcover claim. While your team of lawyers works tirelessly to obtain the full amount of benefits you’re entitled to, they can’t control everything.
Following these few but valuable tips, you’re well on your way to ensuring you receive the benefits you need to treat your injuries and pay you for lost wages.
[dictated by WCV and manually transcribed on behalf of WCV]