After one man twisted his back at work, he experienced lingering pain that interfered with his daily routine. He filed a claim with workers' compensation and was delighted when the adjuster approved physical therapy over surgery. In addition, without the man asking, the adjuster procured an ergonomically designed chair for the man's home office. Workers in California often wish their claims were resolved so positively. Unfortunately, in many cases, workers may be an insurer's third concern after lowering expenses and reducing days off work.
For example, one woman injured her knee when she fell trying to climb over boxes she had repeatedly asked her employer to remove from in front of her desk. Not only did the woman's employer fire her the day after she reported the injury, but her claim was denied because of previous injuries to the knee. The woman resorted to hiring an attorney, and eventually the claim was accepted, but not before the injury had worsened, resulting in lost income and extensive therapy.
Injured workers may hire attorneys because they expect to deal with intimidating and uncompromising claims adjusters. However, studies show that focus on the patient instead of the bottom line often results in positive outcomes for everyone involved. Insurers whose goal is to get the injured employee back to work seem to have better results. They work with the employee to choose appropriate doctors with treatment options that go beyond opioid use. Employees generally want to return to work, and when this is the focus, everyone wins.
Nevertheless, an injured worker's first concern is usually how to manage his or her bills if the claim is denied. Until dealing with workers' compensation becomes a universally positive experience, injured employees in California are fortunate to have attorneys who are passionate about fighting for their rights. Rather than facing hostile and uncooperative claims adjusters, they allow their lawyers to fight the battle for them.
Source: claimsjournal.com, "Five Best Practices to Ensure the Injured Worker Comes First", Dr. Laura Gardner, Nov. 9, 2016