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Delayed Workers Comp Claim

Chattanooga Workers’ Compensation Lawyers

Chattanooga Workers’ Compensation Attorneys Assisting in Cases of Delayed Claims

Strong advocacy when employers assert unreasonable positions or act in bad faith

You work hard for your Chattanooga employer. You help your employer grow financially and provide products and services for the local community. When a workplace accident happens, you deserve fair treatment from your employer’s insurance carriers. After you report your accident, see your doctors, and begin treatment, you have the right to expect the insurance company will only raise eligibility defenses that have merit. You have the right to expect the carrier won’t force you back to work until you’re healthy.

For many workers, the respect they’ve earned is denied. Many workers wait and wait for a reply only to be put on hold, told the carrier doesn’t have the information that’s readily available, or the carrier takes positions they know lack merit. It’s a problem that we hear all too often at Wagner Workers Compensation & Personal Injury Lawyers. Our experienced Chattanooga workers’ compensation lawyers know the tactics used by employers and insurance companies, and we do not let them get away with their bad-faith actions.

What conduct by an insurance company constitutes bad faith?

One of the most common complaints that we hear from new workers’ compensation clients at Wagner Workers Compensation & Personal Injury Lawyers is that their cases have been delayed, and they are having difficulty getting their medical bills paid. This is often what prompts an injured worker to call an attorney.

Your employer or the employer’s insurance company may be intentionally delaying your claim in hopes that you will give up or somehow absolve them of their financial responsibility. At Wagner Workers Compensation & Personal Injury Lawyers, we know how to identify these tactics and counter them with legal skill and integrity.

What conduct by an insurance company constitutes bad faith

Examples of bad faith conduct by an insurance company

Insurance companies have the right to defend their client, the employer, but they cannot be overzealous. They can’t be unfair. Some of the signs your employer’s insurance company is acting in bad faith include the insurance company’s:

  • Failure to acknowledge you timely filed your claim
  • Failure to investigate your claim
  • Failure to respond to your communication efforts – phone calls, letters, emails, etc.
  • Failure to communicate with your physicians
  • Assertion of positions it knows to be untrue such as:
    • Claiming you’re a contractor when it’s clear you’re an employee
    • Denying that your injury requires you to take off from work
    • Refusing to provide a list of company doctors
    • Asserting you have a pre-existing condition when it’s clear that you don’t
    • Claiming you’re ready to return to work when their own doctors say you’re not ready
    • Denying you have a permanent disability when it’s clear you do

Why could my workers’ compensation claim face a legitimate delay?

The insurance carrier does have certain rights. For example, your claim could be denied or delayed because you missed the filing date, or because there was an error in your initial application for benefits. You could also face delays because the insurance company:

  • Requested an independent medical exam (IME). Many employers, through their insurance company, will ask their employees to submit to an IME after the employee has been receiving medical care for a while. A common example is when a worker has had numerous physical therapy sessions for a back injury. The employer can seek the IME to determine whether the employee still needs medical care and how much care. We’ll explain how you should prepare for the IME. We’ll work with your doctor to respond to any disputes raised by the IME physician. We’ll contest unreasonable requests for IMEs. We may, on occasion, request our own IME if a company doctor isn’t helping you.
  • Wants to assign a nurse case manager to your case. Generally, employers can appoint nurse case managers to help you meet your medical appointments. If one is not available, or if there is another issue associated with this part of your claim, your benefits could be delayed.
  • Requested a functional capacity examination (FCE). Your employer may inquire whether you can return to work with restrictions. An FCE provider such as a physical therapist will conduct the FCE exam. We and your employer may also request an FCE to determine the severity/impairment level of a permanent disability. We’ll explain how these procedures work, and what rights you have.

The insurer may have other rights depending on your job status, how the injuries happened, your medical care, and other issues. These rights are not absolute. Employers must comply with the rules of fair play. If we think the insurance company is asserting positions that are unfair, or request items that aren’t relevant, our Chattanooga workers’ compensation lawyers will either deny the request or request a judicial ruling.

How does a delay of workers’ compensation benefits hurt you?

An unreasonable workers’ compensation benefit delay can leave you without payment for months or even years. You may not be able to work. You might not be able to get the medical help you need. Your injuries could heal slowly or not at all. You and your family may be unable to pay your bills or put food on the table. Workers’ comp delays are serious, and we take them seriously.

How can you help if my work injury is delayed?

If your claim is ultimately denied following a delay, our skilled Chattanooga workers’ compensation attorneys thoroughly review your claim, address any deficiencies in the evidence, and respond to every attempt by the carrier to try to deny or limit your claim. If an insurance carrier for your employer is acting in bad faith, we pursue two basic claims:

  • Your current claim. We pursue your workers’ compensation case by filing a new claim if one hasn’t been filed yet, or if your employer promptly and without merit denied your claim. If an agreement cannot be reached, we schedule your workers’ compensation claim before an administrative judge who will listen to your testimony, review the medical evidence, and consider any other relevant evidence on your behalf.
  • A bad faith claim. We request that the administrative law judge order that the insurance carrier provide relevant information and communicate fully with our lawyers. We seek interest due to any delay and additional penalties that the administrative law judge may have the duty to issue.

Do you have a job injury lawyer near me?

Wagner Workers Compensation & Personal Injury Lawyers’s Chattanooga office is located at 701 Market Street, Suite 310. When necessary, we make arrangements to speak with you at your home, a healthcare facility, or by video conference.

A record of strong results from experienced Chattanooga workers’ compensation lawyers

A workplace injury can be extremely stressful when employers and insurance companies fail to act in a timely manner to provide the benefits you are entitled to receive. If you find yourself worrying about a delayed workers’ compensation claim, contact the lawyers of Wagner Workers Compensation & Personal Injury Lawyers. Call us today or complete our contact form to schedule a free consultation with an experienced attorney. We serve clients in Chattanooga and Cleveland, TN and all the surrounding counties.