The Workers’ Compensation system is complex. There are many stakeholders, each with their own interests. The injured worker and payment of timely workers’ compensation benefits should be primary but often the worker is the one with the least amount of legal representation.
The purpose of the workers’ compensation system in Pennsylvania is in place to provide employees, workers injured on the job timely payment of medical and lost wage benefits so they can heal and quickly return to work if at all possible. However there is more to getting compensation when a worker is injured on the job than just filing a claim. Although the system is in place by law it doesn’t mean that it runs on automatic pilot. There are many players and many facets to manage to get a worker back to work and back to whole. That’s one reason why having an attorney with experience in workers’ compensation issues can be so helpful.
Another reason is that while the injured worker is making demands for coverage and care employers are trying to just as energetically cut workers’ compensation costs. Some employers may seek to delay payments of claims by automatically denying initial claims. And insurance companies have bottom lines to shareholders and aren’t in the business to lose money.
For some in the workers’ compensation system, such as insurance adjusters, accountability is their concern. The adjusters have to answer to supervisors and they in turn to boards and directors in turn to shareholders. For many the adjuster is the key to an insurance companies success. These gate keepers of the insurance companies monies have much to review. There are medical providers who fail to properly document, fail to timely report or properly bill. There are employers who don’t properly investigate, or who are overly aggressive, or don’t care. And of course employees, injured, seeking quick redress.
It has been recommended that adjusters:-investigate every claim thoroughly;-look to spread liability around to possible other entities or third parties;-thoroughly read all medical reports;-be attentive to tips about possible fraud;-don’t abdicate their tasks to lawyers;-utilize medical case managers as much as possible;-weekly review each injured worker’s claim and ;-try to get the injured worker back to work as soon as possible.
The workers’ compensation system is complex and there are many who have an interest in the outcome of each and every claim. Each has their own agenda. The injured worker’s health, treatment, recovery and timely payment of benefits should be primary but often isn’t. Often the injured worker is the one with the most to lose and the one with the least amount of legal representation.
For questions regarding your workers’ compensation claim, or your workers’ compensation benefits, contact the lawyers at Dugan & Associates, Lawyers Representing Injured People, at 888-99-DUGAN.