How to Protect Your Workers’ Comp Rights From Insurance Companies

Posted on November 9th, 2021

People often get hurt at work, especially when their job involves manual labor. For this reason, Pennsylvania enacted the Workers’ Compensation Act to assure that workers injured on the job are provided for. This act details every workers’ comp right an employee has, from medical coverage for surgery and treatment to lost wages, and also coverage for pain and suffering.

Typically, your employer doesn’t pay for their employees’ workers’ comp themselves. They make regular payments to an insurance company that is supposed to cover an employee’s recovery. Sometimes, the insurance company will try and find a way to get out of paying an injured employee the workers’ comp they deserve.

How Do Insurance Companies Violate Your Workers’ Comp Rights?

There are tactics they use that violate your workers’ comp rights that you should be aware of, especially if you’re ever injured on the job. While being cognizant of these tactics, Kalinoski Law Offices has a few tactics we recommend using to protect yourself and use your workers’ comp rights for the compensation you deserve.

Make You Use Their Doctor

This may not be a surprise if your employer provides medical insurance. It’s not uncommon for a company’s insurer to have a list of medical professionals you are required to go to for your injury’s examination. These medical professionals commonly receive compensation of their own. This encourages them to give diagnoses that agree with the insurance company’s preference rather than your medical need.

Delay Your Treatment

This may seem rather sinister, but an insurance company can delay you receiving medical treatment to make you see other doctors. They do this if your previous diagnoses don’t match with what your insurance company wants to hear. This directly conflicts with your workers’ comp right to medical treatment coverage by preventing you from medical treatment.

This tactic is more sinister than others because it can lead to your injury growing worse, leaving you with even more expensive bills that aren’t being covered. In the worst-case scenario, their delay leads to you incurring a permanent injury.

Blame Your Injuries on Existing Conditions

Workers’ comp insurance companies can get a hold of your medical bills some way or another. They’ll use this information to try and find an explanation for your injury, rather than it being a side effect of your employment.

This specifically means pre-existing injuries. If a pre-existing work condition led to your injury, such as something wrong with the environment, the workers’ comp insurance company wouldn’t mention it. The only exception would be if the condition was caused by an outside third party.

Claim Your Injury Was Your Fault

This is a self-explanatory claim that even if true, doesn’t always mean they don’t have to cover you. Sometimes, they’ll try to prove that you were intoxicated or behaving recklessly, which you can mount a defense against.

It’s not unheard of, though less common, to accuse you of incompetence. If incompetence led to your injury, that doesn’t preclude you from what your workers’ comp rights promised you. It could even serve as an argument in your favor that you were incompetent because you weren’t trained or supervised properly.

How Can You Protect Your Workers’ Comp Rights?

But how should you defend against these claims? There are common tactics you can use to provide evidence against the ideas that your diagnosis does not necessitate the action it does, or that the accident was your fault.

Get a Second Medical Opinion

Your insurance company cannot keep you from seeing a medical professional not on their approved list of referrals. To get an accurate diagnosis, or to get one to provide proof of injury, get another opinion. This can sometimes mean paying out of pocket, and you should note this as something the workers’ comp insurance company should pay you back for too.

Acquire Documentation Of Your Accident

Your supervisor is supposed to document your accident. You’ll want to retrieve a copy of this record to see if it accurately accounts for events. Whether it does or doesn’t, it can be used as a point of contention in a court case.

Consider Viable Witnesses

Consider who saw the accident that caused your injury. If they can and would act as a witness to events, they can provide a defense against claims that the accident was your fault or when you weren’t working. If you find yourself hesitant to ask another fellow employee to act as a witness, remember that if they are injured, they’ll want compensation too.

Contact a Workers’ Comp Rights Attorney

It’s incredibly difficult to form a strong legal case against a corporate entity without proper legal representation. This makes it near impossible to form one without an attorney.

Each of these tactics will help your legal representation form a strong case that your employer’s insurance provider isn’t avoiding paying you the workers’ comp you deserve, and owes you more now for how your injury and suffering has worsened.

Why Contact Kalinoski Law Offices in Scranton?

Kalinoski Law Offices has been serving the people of Northeastern Pennsylvania for years. The firm has worked hard to earn people the payouts they deserve because we believe that when you’re injured at work, it’s the job of your employer to take care of you. When their method of care does their best to make your suffering even worse to save themselves money, you can contact us for help. We’re always ready.

Category: Personal Injury

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Craig Kalinoski
Craig Kalinoski

Craig P. Kalinoski is a respected attorney serving clients in Scranton, Pennsylvania. With a focus on Family Law, Criminal Defense, and Civil Rights, he has established himself as a top-rated legal professional. Recognized as a Rising Star and admired by peers, Craig's commitment to excellence sets him apart in the legal field.


We fight for the rights of our clients in a wide spectrum of practice areas, ranging from criminal defense to family law and personal injury.

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