As if being injured in a workplace accident wasn’t stressful on its own, dealing with the California workers’ compensation system afterwards is oftentimes an even more frustrating experience.
Due to the system’s notoriously complicated and anti-worker structure, claimants often encounter numerous complications along the way and can experience delays in payment – a costly prospect when considering the steep cost of medical care and the burden of lost wages. This can lead workers to suspect that their attorneys are dragging their feet with their claims, blaming them for all of the delays.
In reality, attorneys deal with the same frustrations as their clients, and they have little control over certain factors within the system that delay a workers' comp settlement.
Reasons Why a Workers' Comp Claim Can Be Delayed
So why is your case taking so long to settle? Below are five ways in which your claim can be delayed:
- Reluctance to pay: Insurance companies are rarely on a claimant’s side. It is important to remember that insurance is a business, and it is not in their best interests to pay claims. As such, insurers may intentionally take their time with a worker’s claim and search for any reason to deny payment.
- Doctor reporting: Your physician may be taking too long to provide the insurance company with the necessary medical reporting. Doctors work with insurance companies on a regular basis and oftentimes owe their livelihoods to them, leading them to act with the insurance company’s best interests in mind. On the flipside, if your doctor believes that you have not reached maximum medical improvement (MMI) after treatment, your claim will stay open until your injuries have stabilized and you are ready to return to work. Until you reach MMI, your case is not ready to settle or go to trial.
- An abundance of fraud: While workers’ compensation is an invaluable resource for many injured and ill workers, unfortunately, the system is full of holes that allow both workers and health care providers to scam the system and fraudulently collect benefits, including feigning symptoms to continue receiving benefits, phony billing, and setting up sham facilities. As such, insurance adjusters search through claims with a fine toothed comb for any potential indication of fraud, no matter how slight, resulting in a delay or denial of any claims that seem suspicious. Hopping between different doctors, seeking unconventional treatments, or seemingly exaggerated pain complaints can all lead an insurance adjuster to flag a claim.
- Legal red tape: Delays can happen within the court system, as there are not nearly enough resources to deal with the massive numbers of appeals from denied legitimate claims.
- Understaffing: The delay could be with the insurance company. It is not uncommon for claims to be assigned to an overworked team that may not even have an insurance adjuster, causing your claim to go weeks if not months without being reviewed.
Minimize Workers' Comp Delays with Humphrey & Associates
While some delays are out of anyone’s control, you can greatly reduce your chances of experiencing a delay by placing your claim in the hands of capable legal professionals.
At Humphrey & Associates, our Orange County workers’ compensation lawyers have recovered more than $400 million for injured clients throughout LA, OC, and the Inland Empire and can ensure your workers’ comp case is handled as smoothly as possible. With more than two decades of dedicated experience, we have what it takes to help you get back on your feet.
If we do not win, you will not pay – call (844) 612-5800 or contact us online today.