Factors That Can Discredit an Employee’s Workers’ Compensation Claim

Employers and workers’ compensation insurance agencies will jump through hoops to avoid paying injured workers what they are owed. While this is an unfortunate fact, it is better for employees to keep this at the forefront of their minds throughout the entire process of filing their workers’ compensation claims. Understanding where employers and insurance companies stand can help an employee act accordingly throughout the claim process.

To avoid paying an employee their fair amount of compensation, an employer’s insurance agency typically searches for the tiniest discrepancies in an employee’s claim in order to discredit them. Here are some of the more common factors that workers’ compensation insurance companies may use to discredit an employee’s claim.

Whether medical attention was pursued

One of the most obvious ways a workers’ compensation insurance company may discredit your claim is by asserting that your injury happened outside of the workplace. To make this type of claim, insurance companies use the employee’s actions against them. If the employee failed to seek immediate medical treatment when they were injured, for example, that factor can be used to discredit the employee.

This is why as an employee, it is best for you to request immediate medical attention for any injuries that happen at work, whether you feel you need medical treatment or not. Once you have the opportunity to be examined by a doctor, the doctor will document your injury and recommend a treatment plan.

Evidence collected from private investigators

In the past, workers’ compensation insurance agencies would – and still do – go to extreme lengths to discredit the validity of an employee’s compensation claim. One of the most common tactics insurance companies used in the past was hiring private investigators.

Private investigators would follow employees who filed compensation claims around in their everyday lives to gather photographic or video evidence of them doing things like running errands in an effort to prove that they were not as injured as they claimed to be. Today, insurance companies continue the use of private investigators to conduct surveillance on their employees, which is not considered illegal.

Social media and online posts

You would think with social media, employers and insurance agencies would not need to use private investigators. Again, the lengths that insurance companies will go to avoid paying for an employee’s compensation claim are endless. Private investigators might also use an employee’s social media account to try and discredit the validity of an employee’s injury.

Any photos or posts of an employee engaged in extracurricular activities like playing sports or exercising can be used against the employee. The insurance company may try to insinuate that the employee’s injury did not occur on the job and instead occurred outside of work, during one of these activities.

Simply put, an insurance company may use any posts or photos on an employee’s social media account against them. If there are any questionable photos or posts not aligned with the employee’s injury, they could be used to discredit an employee’s claim. If an employee recently suffered a foot injury, for example, but has a photo on one of their social media accounts showing them mowing the lawn, it may hurt their claim’s legitimacy.

To avoid any misunderstandings, it would be best for employees to watch what is posted on social media while their claim is open.

An employee’s past actions

Whether the employee filing a workers’ compensation claim is a stellar employee or not, their past actions should not be used to discredit their current claim. However, employers and insurance agencies will attempt to use an employee’s past behavior against them when determining whether the employee’s claim should be discredited. If an employee has engaged in criminal behavior in the past, for example, insurance agencies may try to use that factor against them.

Regardless, an employee’s criminal or any past behavior is irrelevant to their right to receive workers’ compensation benefits and should not be considered as a determining factor for discrediting their claim.

Besides using an employee’s past history to diminish credibility, another reason employers and insurance agencies want to use an employee’s past against them is to prove the existence of prior injuries that could have occurred. Insurance companies may insinuate that the employee’s current injuries were not incurred at the workplace.

Suffering an injury on the job can make it difficult to provide for your family, and finances can become a struggle when your employer discredits your claim. Call a Maryland workers’ compensation attorney at Plaxen Adler Muncy, PA at 410-730-7737, or complete a contact form to schedule a consultation at one of our many offices throughout the state.