Naturally, injured workers have a lot of questions about Workers' Compensation. If you have suffered a workplace accident, you are surely familiar with those questions.
Trying to deal with the system is quite frustrating and time-consuming. Besides, the whole process is long and burdensome, and you may feel you’re being obstructed from getting the benefits you are entitled to.
At some point in the case, you’ll ask yourself: Why do these Workers’ Comp cases take so long?
In this article, we’ll take a closer look at why Workers’ Comp cases are so lengthy and if there is something you can do to change it.
1. Why does it take so long to get Workers' Comp benefits?
Even though it shouldn’t be this way, insurance companies are not there to help you. They will fight tooth and nail to cut costs and medical care throughout the life of a case.
On the side, they use the Workers' Compensation system to prevent injured workers from getting the benefits and care they need, especially when it comes to medical treatment.
For example, if you were injured and went to your private insurance, your doctor would send you prescriptions, tests, or even procedures, depending on your condition. Meanwhile, with Workers’ Comp, you would have to face a treatment authorization process.
This process can last for days, even months when you appeal a denial.
2. What happens if you get a denial?
It is also possible that the insurance company will deny your claim. In such circumstances, you would have to go to trial or take a deposition to get your case accepted and receive the benefits you need.
The problem is that going to court can take a long time, sometimes even months.
In Workers’ Comp, an expedited calendar settles certain issues within 30 days of a request. On occasions, it could take 45, 60 days, or even longer to get the judge’s attention.
For example, if you get a denial and want to go to trial, it could take 60 or 90 days to actually make it. Then you’d have to wait for a similar period for the judge to come up with a decision.
And the worst part is that you don't get any benefits or medical care while you're waiting for a resolution.
3. Is the system really there to help you?
Although it might seem otherwise, the Workers’ Compensation system is specially created to help you as an injured worker. That is its reason for existing, and that’s what it is designed to do.
Nonetheless, in practicality, sometimes you’ll find delays that are not necessarily within your or your attorney’s control.
Let’s take a look at this example.
If you reported an injury and the insurance company denies it, you would need to go to a QME for an evaluation. A QME can also be quite a long process, and it can take months to end, which is something attorneys don’t have any control over.
The QME can say the case is now industrial, in which case it should be accepted. But, as we already know, the insurance company will do what is possible to save money, so they may not pick it up. If this happens, you will have to go to court and wait around a year to hear the verdict.
The state of California sets these processes, and the only thing that you and your attorney can do is play the game within the rules.
4. What can you do if you're facing delays in your Workers' Comp case?
Sadly, these rules are something that neither you nor your attorney can avoid it.
Some of these rules don’t help you as an injured worker, and we can’t change them unless we get our legislators to do something about them.
So, if you have a local state assembly member or state congressman you can reach out to, go for it. We highly recommend that you contact them, write them letters, and do your part to make a difference.
The Workers' Compensation system is designed to help injured workers. The bad news is that the process can be slow and frustrating.
Insurance companies often fight to save on costs and medical care throughout the life of a case, and the system is set up in a way that can make it difficult for you to get the benefits and care you need.
However, there are steps you can take to get the help you need and push for changes in the system. Finally, remember that you don't have to be alone in this. An experienced attorney will guide you through this journey and help you get the best possible outcome.
Need help with your case? Contact Pacific Workers’, The Lawyers for Injured Workers for a free, confidential case evaluation. Call us at 800-606-6999 or make an appointment here.