What are the top ten dirty tricks insurance companies use to reduce your workers compensation benefits to deny your claim? If you don't already know, you will by the end of this video. These are tricks that I've repeatedly seen over the past 17 years as a worker's compensation lawyer, but I wish every injured worker who walked into my office was familiar with.
And as a bonus, I'm also going to share my best tips for how to protect yourself from each of these. So stick around for the end to find out.
One way workers comp insurance companies trick injured workers by catching them early in their case. When you first get injured, you have no idea what to expect. And the insurance company will try to take advantage of that fact.
You don't know how long you're going to be out of work, how much medical treatment you'll need along the way, whether you'll have any permanent disability, or what your case is worth. You also don't know whether or not the insurance company is on your side. Well, here's a spoiler alert: They're not.
So when they reach out to early on in your case, offering you money, there's a good chance you might accept it. Only to later discover that the money they gave you wasn't nearly enough to cover all your future expenses.
Another dirty trick insurance companies used to cheat you out of workers compensation benefits is getting you on the record. This is particularly common in larger cases with bigger accidents and injuries. You might be contacted by an insurance adjuster or an investigator who says they need a recorded statement to avoid any misunderstanding, or to get a clearer record of exactly what happened.
But what they're really trying to do is to get you to lower your guard and say the wrong thing on the record. Your statements can then be used to question your credibility in court and to reduce your benefits. We've even seen insurance companies send investigators to get a statement from the parents of our clients. They're ruthless. They'll do whatever they have to in order to hurt your case.
So don't give statements. Don't talk to anybody. Get a lawyer, and then all you ever have to tell anybody is call my lawyer, here's his number.
Another tricky way insurance companies reduce your workers compensation benefits is by making convenient miscalculations. We had one case where a gentleman worked as a super for multiple buildings, and his employer paid his salary through three different corporations, each of which owned a separate building.
So when my client got injured at one of those buildings, the insurance company only used the salary amount that was associated with that one building, which was just a third of his total overall salary. This isn't the only way they’ll miscalculate your salary, so review your average weekly wage carefully to make sure the insurance company's using the right amount.
How, you might ask? By getting your paystubs and tax returns and making sure they line up with what the insurance company is reporting you earn. Otherwise, you could be looking at a fraction of the cash benefits you would otherwise receive.
The most notorious way insurance companies try to reduce your workers compensation benefits is by spying on you. They're doing this more and more every day.
And believe me, if they're going to spend the money on surveillance, then they are going to try to use it. We had a client a few years ago whose wife owned the multifamily building that they were living in. He was home on comp, unable to work or do anything because of his medical restrictions. So the insurance company sent an investigator who knocked on the door pretending to be an interested renter and asked to see a vacant apartment in the building.
My client said, “Well, my wife is the one who will show you the apartment. Come back when she's home.” But the investigator persisted. “No, no, no,” he said, “I'm really pressed for time. I'd like to check it out now.” So our client tried to do the right thing, and he walked upstairs, and he unlocked the door, and let the gentleman into the empty apartment and said, “Take a look around. Please lock up when you're finished, and let me know when you're done.”
And what did the insurance company do there? They claimed he was committing insurance fraud and accused him of working and showing apartments. So they're going to do everything they can to hit you. If you want to learn more about surveillance, I’ll include a link at the end of this video explaining all the ways they spy on you.
Next, insurance companies will use any white lie like a sledgehammer on your workers compensation case. If we're in a trial discussing the facts of your case, and the insurance company finds that you said one thing one time, and something different another time, they're going to hit you with it and they're going to keep hitting you with it.
Then they're going to sum up at the end of your case saying, “Look Judge, they couldn't even remember this one little fact. How can we believe anything that this person said?” And now the judge has a reason to reduce or deny your benefits.
This is especially important when it comes to preexisting conditions, which we're going to talk about in just a moment. So please make sure you're always upfront and honest about your prior accidents, injuries, and conditions. And when you’re In court answering questions from the insurance company or the judge, make sure you stop and think about your answers before you blurt them out.
This could mean the difference of thousands of dollars for you. Coming up are some of the dirtiest tricks yet, as well as my tips for how to protect your workers comp benefits.
Before we move on, I wanted to let you know that we are currently accepting new clients. My name is Rex Zachofsky, and I became a New York Workers Comp lawyer 17 years ago after getting injured on the job. If you're looking for a lawyer to help you with your claim for New York State workers compensation benefits, please give me a call today at 212-406-8989 to schedule a free consultation.
Blaming preexisting conditions probably does more damage to workers compensation claims than any other dirty trick in the book. And there's a reason why insurance companies are so fixated on preexisting conditions because it's one of the best ways to fight off a workers compensation claim.
So they're likely to do everything they can to use that old injury against you if they can't outright deny your case. And they might claim that only a portion of your current injury is related to this current accident. And if your preexisting condition was caused by an old work injury, they might claim that the previous insurance company that handled it is responsible for your treatment now,
and not them. Sometimes they can even get a doctor to play along and blame everything on the condition by claiming your back injuries due to Degenerative Disk Disease, even though you were able to work just fine before your accident. Now, does that mean you should hide preexisting conditions from them? Of course not! As we just discussed, they'll use the fact that you concealed your preexisting condition as proof that you're being dishonest, so you need to come clean about it. I'll share tips for how to protect your case from this argument in just a moment.
Now, why would the insurance company delay your workers compensation case when it's in their best interest to wrap it up? Because they think you'll give up!
They know that injured workers are in desperate situations and likely worried about money. So it's not unheard of for them to ignore you, hoping you'll get nervous and frustrated that you'll give up and go back to work. This is particularly common if you don't have a workers compensation lawyer. When they see you're unrepresented. they might do things like ignore your request for treatment, hoping that you'll put it through your private health insurance.
But don't let them discourage you. Be polite but persistent, and follow up in writing as much as you need to. And better yet, get a lawyer involved!
Can an insurance company actually trick you into going back to work? Well, believe it or not, it's possible. What happens is you'll get a letter from your employers saying, “Good news! We've got the doctor's report saying that you're able to do certain work, and we're able to accommodate your restrictions to come back. And we'll give you light duty work that fits within the doctor's recommendations.”
What they conveniently omit is the fact that it wasn't your treating doctor who cleared you for light duty, but it was the doctor who works for the insurance company. Then when you don't take the job, they’ll threaten to use it against you to deny your workers compensation benefits.
The thing is, you don't have to listen to their doctor's recommendations. You only need to follow your doctor's instructions. So if you get that letter inviting you back to work, always check with your doctor before agreeing to anything.
There are all kinds of ways workers comp insurance companies will get injured workers to slip up. If they engage you in conversation, they could get you to say something that contradicts an earlier statement. And when you're under oath in court, they can work you into a rhythm of answering questions
So you stop thinking. You just stick to the rhythm that sounds good. Duh, Duh, Duh? Yes. Duh, Duh, Duh? No. Duh, Duh, Duh? Yes. And you end up saying something you didn't really mean. I've even seen them ask questions on a form in such a way that gets you to contradict what you previously said under oath.
That's why I tell all my clients that I don't want them filling out forms. I don't want them giving statements on a phone call. And I don't want them talking to anybody about their case.
And when you absolutely have to answer questions, which is only generally in court, go slow. Think carefully and then only answer the question that you were asked. These insurance company representatives are trained to get you to slip up. Don't give them the chance.
When all else fails, insurance companies will resort to threats and high pressure tactics to scare you out of your workers comp benefits. This is more common later in your case, because the longer your case drags on, the more money it costs the insurance company. So you might find yourself facing intense pressure from them to settle.
For example, they might send you a settlement offer and tell you that it's the only one you're going to receive, so you should take it or leave it. Then they'll only give you a week or 30 days to respond before supposedly taking it off the table.
They'll also threaten to appeal your case if you don't settle, which will result in a long, drawn out process that will take forever. Don't listen to them. It would cost them more money to go through a lengthy appeals process than it would to negotiate a fair settlement.
They're just trying to scare you into accepting a small settlement without thinking through the consequences. So don't fall for it.
As a workers comp lawyer with over 17 years of experience, what are my tips for protecting your case from the dirty tricks used by insurance companies? Well, first, these detailed as possible when discussing your injuries with your doctor to make sure it's all properly documented.
This is particularly important if you have preexisting conditions. You need to make sure the medical evidence proves that your injury was caused by a workplace accident, and your current level of disability is due to that accident. If possible, find a doctor who specializes in the type of injury that you sustained. Get them to testify that your work related injury played a significant role.
Next, make a written record of all the facts related to your injury and keep a copy of it, along with copies of all correspondence with your doctor, your employer, and the insurance company. And finally, make sure you understand your rights and the benefits that you're entitled to. The insurance company’s hoping to prey on the fact that you don't know what's going on. Don't give them that satisfaction!
Learn how the workers compensation system works so you can get every penny that you're owed.
And if you want to learn more about how insurance companies spy on you, be sure to watch my other video on surveillance. In it, I explain which type of workers compensation cases tend to get surveillance, how investigators spy on you, what they're looking for, and what you should do to protect yourself. I'll include a link to that video here. Good to watch next, and I'll see you there!
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