The Law Office of James R. Snell, Jr. May 2018

18 MAY

Road to justice |

The Workers’

Getting injured at work is nobody’s idea of fun.When the worst

the reason for this misunderstanding, you should have an attorney look over your policy to ensure you are receiving

Comp System Isn’t Always Fair

happens, you’d like to think your employer would have a policy in place that’s designed to benefit you. Unfortunately, that is not how our workers’ compensation system is set up. Because your employer has to defer to their insurance provider and that provider will do what’s best for their bottom line, employees often get shortchanged.That’s why legal representation

all the benefits available to you.

Another common problem is employees discussing their claim with an insurance representative without realizing that the representative has a vested interest in denying their claim. It’s important to know that these conversations

can be crucial for your workers’ comp claim.

For smaller claims, like those concerning simple injuries from which you’ll make a full recovery, you probably don’t need to hire an attorney. These cases are usually just a matter of covering a small amount of missed work and rarely run up against denials from the insurance company. You may need to have an informal hearing in front of the South Carolina Workers’ Compensation Commission (WCC), but it will be a straightforward affair. Usually, it’s just a matter of making sure you are compensated for whatever period of work you miss. More serious injuries involve more serious claims. These are the claims that incentivize the insurance company to make every effort to win through attrition. Most employers opt for the lowest-premium option for workers’ comp insurance. That may be a decision based on abstract economics, but it can have a real impact on workers. The math is pretty simple. The only way a company can charge lower premiums is by denying claims or paying out as little as possible. If you don’t have an expert looking out for your best interests, it’s easy to get shortchanged. I want to be clear; I don’t think this process is the result of purposefully nefarious actions by evil people. Nobody is out there taking joy in duping injured workers — at least, I hope not. What it comes down to is an interconnected system that puts workers at the bottom of the totem pole. It’s an attorney’s job to make sure your voice is heard. We’ve seen all sorts of underhanded tactics deployed in service of minimizing the value of claims. An employee may be told they aren’t eligible for certain benefits when in fact they are. That might be the result of a manager who doesn’t understand the nuances of a compensation policy or a green insurance rep who doesn’t have the full picture. Whatever

are not with a neutral party. You are under no obligation to speak with an insurance rep in this manner. Instead, you should seek out the advice of an attorney before you accidentally harm your claim by saying the wrong thing. The relationship between doctors and insurance companies can create a conflict of interest in regard to workers’ comp claims. The doctors covered under your insurance policy work directly with your provider. As a result of this relationship, doctors may err on the side of an overly tentative diagnosis. Again, I don’t think doctors are intentionally acting in bad faith. They are just predisposed to deliver a report that matches what the insurance company believes. To help remedy this, we work with a number of doctors who can objectively assess your condition and present their findings to the WCC.

Do I wish the workers’ compensation system were set up to better serve workers? Of course. Am I holding my breath for that day to arrive? Definitely not. Whether I like it or not, it’s on the employees to prove the validity of their workers’ comp claim. Luckily, an attorney can help you do just that. –Jim Snell | | F: 803-359-7691 | P: 803-753-1476 1

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