5 Common Mistakes Made By North Carolina Workers’ Compensation Claimants
1. Settling a North Carolina workers’ compensation claim without assessing the true value of that claim.
Even if a claimant has sustained a relatively minor injury, such as soft tissue damage to the pad of the thumb or shin splints from lifting heavy objects, he/she may be ultimately entitled to collect North Carolina workers’ compensation benefits for an entire lifetime. It’s a fact of human psychology that people tend to over-emphasize the difficulties associated with acute injuries and underestimate the difficulties associated with chronic injuries. Thus, particularly when it comes to chromic injuries, claimants tend to undervalue their claims.
2. Thinking that the insurance company is on your side.
Insurance companies are in business for one reason and one only reason only — to make money. To stay competitive, insurers go through rigorous processes to shave costs and minimize payouts to policyholders. In other words, the insurance company exists in large part to DENY as many claims as it can get away with. This isn’t to say the insurers are malicious. But they are most assuredly NOT working for you (even if individual associates appear sympathetic and helpful.) To that end, if you volunteer information about your condition — even by saying relatively innocuous things like “I’m feeling better this week” — your statements can be manipulated, taken out of context, and leveraged against you in the future.
3. Signing an incomplete agreement within the insurance company.
Let’s say the insurance company agrees to settle. If so, the claimant will receive what’s known as an “agreement to pay” from an adjuster. This agreement can be quite complicated, so it’s often in claimants’ interest to have it examined by a competent North Carolina workers’ compensation attorney. Not all of your injuries may be included on the form. For instance, perhaps you hurt your arm AND suffered a finger sprain. If the agreement only stipulates that your arm was injured and you do not correct the form, you may not be able to recoup any costs associated with the treatment of your hand.
4. Even after your claim has been accepted and approved, insurers can still investigate you.
Often North Carolina workers’ compensation claimants feel that they are “in the clear” after settling successfully with insurers. However, this can be a serious mistake. Insurance companies often reserve the right to investigate claims even after they have been processed and paid out, particularly claims for chronic disabilities. Indeed, insurers have gone to incredible lengths to retract, amend, or otherwise renegotiate claims, including, for instance, secretly videotaping claimants.
5. Believing that you can choose from an indefinite number of healthcare providers.
North Carolina workers’ compensation rules limit your choice of providers. An employer or an insurance company may offer you a choice of physicians from a pre-selected list. Once you choose a doctor, it can be very difficult and time consuming to “deselect” that doctor and find someone else… without risking your benefits.
Web Resources
North Carolina Industrial Commission
