When a workplace injury is reported to an employer, it is always hoped that the employer will cooperate accordingly and will report the injury to the proper channels to ensure that the injured employee is compensated.
However, cooperation does not always occur so easily, and sometimes companies will knowingly mislead the insurance company about the injury and about what happened. What are the employee’s options in these situations?
We have asked lawyer, Alaina Sullivan, and here is what she had to say:
Employer’s Duties for Workers’ Compensation
Employers are required in essentially most states to provide workers’ compensation insurance if they hire a certain number of employees. In addition, they have a number of other duties, such as posting notices of compliance with workers’ compensation laws that need to be posted in obvious locations in the workplace.
Further, employers must provide immediate emergency medical care for employees who sustain injuries while at work or offer further medical attention if the injured employee is not able to select a doctor.
The employer is required to complete a report of the injury or incident and send this report to the state’s workers’ compensation board location, along with a copy of the report being sent to the worker’s compensation insurance provider.
The employer is also charged with complying with any further requests made regarding the injury from the workers’ compensation board or insurance company, including requests for what the employee’s earnings were at the time of the accident, reports of the employee’s date to return to work and any other status updates regarding the employee’s recovery following the injury.
Employer’s Failure to Follow Duties
Consequences do exist for if and when an employer fails to follow the law when it comes to reporting a work-related injury. If the employer chooses to not accept responsibility for the injury, the injured employee is entitled to report the injury himself or herself to the state workers’ compensation commission.
Worker’s compensation is not an optional system. It is mandated, which means that if the injury happened at work, the employer cannot simply ignore it and choose to do nothing. If the employer refuses to send the report to the proper channels, he or she can get into a great deal of trouble.
This trouble may result in the employer being guilty of a misdemeanor and receiving a fine for the failure to report. It is hoped that having these punishments as a possibility for not reporting an injury that the employer may be convinced to report the incident appropriately.
An injured employee is completely within his or her rights to go over the employer and report the injury directly to the state’s workers’ compensation agency to get the process started for compensation.
An entirely separate and equally as serious situation occurs when the employer does report the injury but then knowingly misleads the insurance company regarding what is going on. In this situation, the employer could be committing insurance fraud.
At that point, it is appropriate for the employee to report the employer to the workers’ compensation board so that they can appropriately investigate the situation and determine how to handle it from there.
These reports can be made anonymously if the employee fears retaliation from the employer if the incident is reported and it is later discovered that the injured employee blew the whistle on the employer. Many employees choose not to make these reports for fear of the possibility of retaliation.
Employers are legally not allowed to do this, although the fear of this possibility is quite real.
It is recommended that the employee speak with a workers’ compensation lawyer before making any decision on how to handle an incident, especially if the employee fears the possibility of retaliation in the event a report is made.
A lawyer can also help the employee properly submit the claim if the insurance company does not have all of the correct information to properly process the claim for the employee.
Contact a Lawyer Today
If you are in the process of pursuing workers’ compensation and have questions about your employer’s duties when it comes to filing a claim, a workers’ compensation lawyer can help review your case and discuss your options.
A lawyer can listen to the facts of the case and can best advise you on how to proceed. Contact a lawyer experienced in workers’ compensation law to schedule a consultation today.