What Can Prevent You from Receiving Workers' Compensation?

workers compensation form

If you are suffering from a workplace injury, it can be a very challenging experience for you. Not only do you have pain and suffering caused by the injury, but you may be faced with medical bills and other expenses that you can’t pay.

Many workplace injuries make employees unable to perform work duties, either temporarily or permanently. It can take a few months or even longer to heal, and you may wonder how you are going to provide for yourself or your family while you are out of work.

Workers’ compensation can assist you during this difficult time. Workers’ compensation claims handle any expenses related to injuries that happened on the job. These expenses can include hospital visits, tests, scans, surgeries, and physical therapy costs. Workers’ compensation also covers any permanent disabilities that result from a workplace injury.

What Not to Do During a Workers’ Compensation Case

If you are injured in on the job, you may be confused and unable to make clear decisions about what to do. You need to take certain steps to ensure that you do not jeopardize receiving workers’ compensation for your injuries and lead to the insurance company or employer stopping your workers’ comp checks. These are the mistakes you need to avoid when working with your doctor, your employer, and the employer’s insurance company.

  1. Not Documenting Your Workplace Accident
    If you are able, you need to document what happened and how you were injured right away. While your co-workers might witness your injury and offer to help, they will only be able to document their version of the incident. Your account of how you were injured will be crucial in determining your workers’ compensation case. It’s important to take notes about statements that your co-workers or medical personnel made on the scene. Even details that may seem insignificant could be critical to your workers’ compensation claim. The longer you wait to write down these details, the more likely you will forget them. Any injuries, pain, or symptoms that you experience should also be documented. Keep track of your doctor visits and medications that you are taking and document them in a spreadsheet. It is important to keep copies of bills, medical records, lab reports, travel expenses (to and from appointments), and any other costs associated with the injury. Request a copy of the accident report to keep for your records, and make sure it is accurately filled out.
  2. Not Providing Your Doctor with all the Details of Your Injury
    Not only is it essential to inform your physician about all the details of your workplace injury, but also about any pre-existing conditions you have suffered. Pre-existing conditions include prior injuries you had before the accident or injuries that occurred to the same part of the body as the current injury. Be honest with your doctor about your symptoms and any changes to these symptoms that you experience. If your injury is getting better, you need to let your doctor know that as well.
  3. Exaggerating Your Injuries and Symptoms
    To strengthen a worker’s compensation claim, some employees may embellish their symptoms or fabricate other injuries. Your doctor will most likely perform several tests during your examination to determine if you are exaggerating your injuries. If he or she believes you are falsifying symptoms, it will damage your workers’ compensation case. Also, embellishing your claim is considered insurance fraud and is illegal.
  4. Seeking Medical Care
    Under workers’ compensation law, the insurance company or your employer directs your medical care. Except in the case of emergency situations, they must authorize any care you receive. You are entitled to a second opinion about treatment options and/or a second opinion about a disability rating.
  5. Not Following Your Doctor’s Advice
    It is imperative that you follow your doctor’s advice and treatment plan. Failing to follow your doctor’s advice may lead the insurance company to make a determination as to whether your injuries are legitimate or not. You may feel better and then assume that it is okay to discontinue care. Sometimes, symptoms may diminish during treatment but can return or get worse later if you stop following your treatment plan.
  6. Not Returning to Work on Light Duty if Permitted by Doctor
    Your physician may advise you to return to work with fewer responsibilities than you had prior to your injury. Failure to return to work when it is approved by your doctor will only harm your workers’ compensation claim. If you do not feel able to perform the duties required, it is important to discuss this matter immediately. While on the job, take notes if you have any discomfort, pain, or other symptoms that occur. Your doctor can make any revisions to your work duties as necessary.
  7. Performing Work Duties Beyond Your Doctor’s Restrictions
    Even if you are injured or in pain, you may be tempted to perform more work duties than what your doctor recommends. As easy as it might be to move furniture or lift boxes on your own, it is important to ask for help, otherwise, you risk the possibility of re-injuring yourself.
  8. Giving a Recorded Statement
    As an injured worker, you should have an attorney present for any recorded statement. Any statements you make will be used against you in a workers’ compensation case. The law on worker’s compensation is complex especially when it comes to occupational diseases. A wrong word can jeopardize your rights.
  9. Not Confirming that the Workers’ Compensation Adjustor Has Correctly Determined Your Average Weekly Wage
    When determining your average weekly wage (AWW), the insurance adjuster should include overtime hours, holiday pay, vacation pay, bonuses, or other salary incentives when calculating your average weekly wage. However, some adjusters neglect to do this or figure out the incorrect amount for your workers’ compensation pay. The average weekly wage is determined by adding up the total amount of pay for the 52 weeks prior to your injury and dividing it by 52; the resulting number is the AWW. However, if you have periods of time greater than 7 days that you did not work that time period should be excluded from the calculation.
  10. Not Hiring a Lawyer
    An insurance adjuster does not have your best interests at heart. The adjuster’s task is to pay you the least amount of benefits that are necessary because it is in the best interest of the employer and the insurance company. An experienced workers’ compensation lawyer can assist you with several issues that may arise in your case. Your attorney should know about your current medical conditions, any medical treatment received, any legal or financial matters, and your employment history. It is imperative that your lawyer is aware of any issues that your employer’s insurance company can use to discredit your workers’ compensation claim. With this information, your attorney will be able to effectively fight for you by ensuring you receive proper compensation or evaluate the amount of any settlement that is proposed.

Helpful Tips for Dealing with Your Workers’ Compensation Case


  • Some employees do not report injuries because they seem minor, or the pain or damage will pass quickly, or they report an incident to their supervisor later. When injured on the job, it is crucial to notify a supervisor immediately following the accident. If you wait to report the incident, the insurer may doubt the credibility of your claim.
  • If you are seriously injured, allow the emergency responders to transport you to eliminate the risk of further injury. Any injuries sustained should be immediately reported to your employer. Your employer should have an in-depth report of how the accident happened and a list of all workers and witnesses that were involved.
  • Make sure that you get eyewitness testimony, either verbal or written, from witnesses who saw the accident occur. If the insurance company tries to deny the claim, you will have these statements to include as evidence.


  • Don’t let anyone talk you out of reporting the incident. Your employer may try to pressure you to keep it quiet to save the company money or their reputation. If your employer offers to pay you under the table instead of filing a claim, decline and make a formal report of the accident.
  • Don’t discuss your case with anyone outside of your doctor, your spouse, and your attorney. Statements made to other people could be used against you in your case.
  • Don’t think about settling your case before discussing it with an attorney and learning about your legal rights and options.

Contact Our Workers’ Compensation Lawyers in North Carolina

If you have been injured on the job, you are probably overwhelmed with dealing with insurance companies, doctor’s appointments, and missed time from work, as well as pain from your injuries.

The lawyers at Younce, Vtipil, Baznik & Banks, P.A., know what you’re going through. Two of our lawyers are Board Certified Specialists in workers’ compensation. We will be able to help you with all aspects of your North Carolina workers’ compensation case so that you can focus on your recovery. Contact us at (919) 351-8827 for a free consultation today.