When your workers’ compensation claim is denied, the battle for benefits begins, and the insurance company’s defense attorneys will do everything in their power to minimize your payout or deny your claim entirely. While workers’ compensation laws are designed to protect injured workers, the reality is that defense attorneys have many strategies they use to challenge your claim and discredit your case.
In this article, we’ll pull back the curtain on the tactics defense attorneys use in workers’ compensation appeals and how you can counter them. Whether you’re dealing with a dispute over the cause of your injury, an independent medical examination (IME), or surveillance, understanding these strategies will help you build a stronger case and increase your chances of winning your appeal.
One of the most common tactics defense attorneys use is to dispute the cause of your injury. They may argue that your injury didn’t happen at work or that it was caused by a pre-existing condition. To counter this, defense attorneys often rely on the following strategies:
Defense attorneys may dig into your work history, looking for any indication that your injury was caused by activities outside of work. They may argue that your injury was the result of a hobby, a previous job, or an unrelated medical condition.
Your medical records are a key part of your workers’ compensation claim, but defense attorneys will scrutinize them for any indication that your injury is not work-related. For example, if you’ve ever seen a doctor for a similar injury in the past, they may argue that your current injury is a result of that pre-existing condition.
Defense attorneys often try to downplay the severity of your injury, arguing that it’s not as serious as you claim. They may use several tactics to do this:
In many workers’ compensation cases, the insurance company will require you to undergo an independent medical examination (IME) by a doctor of their choosing. These doctors are often hired by the insurance company and may provide biased opinions that downplay the extent of your injuries.
Defense attorneys may hire private investigators to conduct surveillance on you. If they catch you engaging in physical activities, even something as simple as walking or carrying groceries, they may use this as evidence to argue that your injury isn’t as severe as you claim.
In both Iowa and Nebraska, workers must report their injuries within a certain timeframe to be eligible for workers’ compensation benefits. Defense attorneys often use this to their advantage, arguing that you didn’t report your injury in time or that there’s a delay between the injury and the report.
If your injury has left you unable to return to work, defense attorneys may argue that your disability is temporary or that you’re able to work in another capacity. They may also argue that your impairment rating is lower than what your doctor has assigned.
Defense attorneys may try to offer you a low settlement to avoid paying the full value of your claim. These settlements often come with strings attached, such as waiving your right to future benefits.
When your workers’ compensation claim is denied, defense attorneys will use every tactic at their disposal to minimize your benefits. But with the right strategy, evidence, and legal representation, you can counter these tactics and win your appeal.
At Ironclad Injury Law, we specialize in workers’ compensation appeals in Iowa, Nebraska, and other states. We know how defense attorneys operate, and we’re ready to fight for the benefits you deserve. Contact us today for a free consultation, and let us help you navigate the appeals process and protect your rights.
