If the insurance company believes that the claim might be false, they might request that you be subjected to an independent medical examination.
To be eligible for workers’ compensation benefits, you have to prove that you were engaging in work-related activities when you were hurt. It isn’t enough just to be injured while you are at your place of work; you must show that you were working under the authority of your employer and the scope of your duties.
To collect workers’ compensation, you also have to show that you were in fact injured, and prove the extent of your injuries by having official documentation from a physician. So if you are hurt while on the job, it is imperative that you seek medical attention and make your employer or supervisor aware that you have been injured. If you fail to do so, it might be possible for the insurance company to question how your injury happened and question whether or not you can collect workers’ compensation.
How the Insurance Company Might Try to Deny Your Claim
There are times when an insurance company might seek to claim that you aren’t entitled to collect. Circumstances where they might try deny coverage include if the insurance company can prove that you weren’t performing work-related activities. They might also challenge whether your injuries were as extensive as you claim they are – or in some instances, if you were even injured at all.
If the insurance company believes that the claim might be false, they might request that you be subjected to an independent medical examination. An IME is when you have to be seen for a second opinion by a physician selected by the insurance company. Although they get to choose the physician and you don’t have to pay for it, you are required to comply. If you refuse, it might be possible for the insurance company to deny your claim or to stop paying benefits.
If your physical and the IME show different results or come to differing conclusions about your injuries, it is important to discuss your case with an experienced workers comp attorney. If the insurance company is reducing your payments, denying your coverage, or demanding that you return to work, and you feel as if it is the wrong decision, then you are entitled to a hearing for an appeal. To ensure that you have more than even footing with the insurance company it is important that you have a qualified attorney on your side.
If you have been injured on the job in the state of Missouri, call the Law Office of James M. Hoffmann 24/7 at (816) 256-430.