Why Do Workers’ Comp Cases Move So Slowly?

Reasons for delays in workers’ compensation cases and what you can do about it

Don’t hate the player, hate the game.

Former Florida Gator and NFL player, Tim Tebow, has stolen hearts as a football player for years now. Tebow recently decided to leave football and the SEC Network to play baseball. As he signs with the New York Mets, we are reminded that we don’t hate Tebow, we just hate the game he has chosen. (Not really, but please bear with us on this. We do like baseball.)

The same can be said for workers’ compensation. Don’t hate your attorney, hate the system. 

When the goal of a workers’ compensation claim is to receive benefits to provide for recovery of an injury, the light at the end of the litigation tunnel seems distant without incurring any delays. Filing a workers’ compensation claim can already seem like a minefield of unknowable traps and obstacles lying in wait without accounting for the likelihood that your case’s end could be pushed back again and again. 

When medical bills are piling up, the financial stress only adds to the pain of the injury. If it feels like your workers’ compensation claim is taking longer than you hoped, chances are you’re right. These claims can take a long time. The specifics of your workers’ comp claim and whether your claim is approved or denied can determine the length of time that passes before you receive benefits. 

That is typically not your attorney’s fault. More than likely, your attorney is doing everything they can to get your claim resolved or before a judge. 

Unfortunately, the system by which the case moves is time-consuming and tedious.

Rather than leaving more questions unanswered, this article’s aim is to shed some light on what goes on behind the curtain of your workers’ comp claim.

How to start a workers’ comp claim

Written notice of your injury to your employer must be given within 90 days of the accident for the injury to be compensable, though reporting the injury within 5 days is recommended. After this, the statute of limitations allows you 2 years to file a claim for workers’ compensation benefits.

In turn, your employer will notify its insurance provider of the claim for benefits in order to determine the compensability of the injury. This is the starting point of using delay as a tactic against the employee during the compensation process.

How insurance companies delay the workers’ comp process

It’s imperative to keep in mind that insurance companies, like any other corporation, operate for the purpose of turning a profit. While insurance firms may market themselves as for the people or for the employee’s benefit, the financial bottom line is still a driving force of its operation. 

This leads to insurance adjusters employing tricks to cause undue delays when responding to claims. For example, an adjuster for the insurance provider may ask for an employee to provide information to the insurance firm that is not needed but takes time to produce. Once the information is provided, the adjuster may take longer than necessary to respond to emails or communications from the employee, causing further delay.

How does delaying a claim benefit the insurer?

The purpose of the delay is twofold. On the one hand, it prolongs the time until the insurance provider must pay out the benefits to the claimant, and on the other, it weakens the position of the employee, creating a dire need for benefits so that the employee is willing to accept a lower settlement offer. 

Insurance companies maintain funds in interest-accruing accounts. The longer a larger sum is left in the account, the greater the return on the principal. This creates the incentive for insurance companies to delay paying out large lump sum benefits. 

How does delaying a claim hurt the injured worker?

The delay in a return on the claim, in turn, creates a struggling financial situation for the injured employee who cannot return to work yet has medical bills stacking up that must be paid. When money is sorely needed, the insurance provider can often get away with paying less to an employee without legal representation, who will take whatever they can get to avoid amassing debt.

An experienced workers’ compensation attorney can help prevent this scenario, but the workers’ compensation filing process will take time regardless, so the sooner you contact an attorney, the sooner you can start receiving benefits.

How a workers’ comp claim moves through the legal system

After you hire a workers’ compensation attorney, they’re able to pursue your claim with the insurance adjuster on your behalf or file a lawsuit with the Circuit Court (or both). Once the complaint is filed, your employer has 30 days to file an answer to the complaint. After that, the process goes as follows.

Discovery period

A hearing is usually set on the matter. During the interim, your attorney will request discovery (documents related to your claim) from the opposing counsel. Opposing counsel has 30 days to respond to the discovery request and send any documents related to the claim.

Deposition

Your employer also has a right to conduct a deposition, which involves a question-and-answer session under oath. Since attorneys have fairly busy schedules, the deposition could be when your first hearing is scheduled, which means the hearing will be reset or continued.

Play Video: Tips When Preparing for and Taking a Deposition

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Medical record request

Typically after a deposition, your employer may request medical records from any doctors you may have seen about your injury. They can also request records from your employer about any benefits you’ve received. These records take time to receive, usually 30 days at least.

Reaching maximum medical improvement

Another factor in this is the timing of when you reach maximum medical improvement. That is a term used in the workers’ compensation claims for when the authorized treating physician is of the professional opinion that the injured patient has reached the end of their healing process. 

At this time, the doctor will usually assign a permanent impairment rating and determine if you’re able to return to work with restrictions. These things are needed to help shape the value of the claim.

Vocational evaluations and depositions

But even after maximum medical improvement is reached, many things have to be done to get the case ready for trial, including vocational evaluations and depositions of doctors and vocational experts. These things add even more time to the process.