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3 reasons employers may question a workers’ compensation claim

On Behalf of | Apr 4, 2023 | Workers' Compensation

The idea that grounds workers’ compensation coverage requirements is a good one. Ohio businesses can protect themselves from the possibility of financial liability for a worker’s injury or illness by providing such coverage. Additionally, workers also benefit because they don’t have to worry about covering their care costs or going completely without income after developing a medical issue related to their job.

However, workers’ compensation claims can often become a challenge for an employer to handle. Significant claims can drive up insurance premiums. As a result, abuses of this system are not issues that should be approached lightly.

Occasionally, businesses may have questions about a workers’ compensation claim and whether the employee who has filed it has a legitimate right to benefits. These are the most common reasons that employers question a claim related to a work-acquired medical condition.

They disagree about the origin of the issue

Perhaps a worker claims that they hurt their back in the warehouse, but the injury just happened to occur first thing Monday morning when they moved house the weekend before. When an employer has reason to question whether the injury actually occurred on the job, they may challenge a claim until they can resolve their questions.

They think a worker can stay on the job

Sometimes the dispute isn’t about why or forgot hurt but rather the impact that their injury will have on their job performance. Many companies can assign someone to different job responsibilities or offer them other medical accommodations while they recover from an injury or repetitive stress, which means that they don’t need a leave of absence and disability benefits. Employers may challenge part of a claim if they think that a worker can return to the job without putting their health at risk.

They believe the worker caused the injury on purpose

Although it is rare, sometimes companies have reason to believe that a worker may have hurt themselves intentionally. When a worker unintentionally causes their own injury, they should still qualify for benefits regardless of fault. However, if they heard themselves on purpose, then they may not be eligible for benefits.

Leadership at a company that is questioning a worker’s actions or a claim that they have made for injury-related benefits may benefit from learning more about workers’ compensation rules and defense strategies. Asking thoughtful questions of an experienced legal professional under these circumstances can potentially help protect employers from consequential abuses of the workers’ compensation system.