This is not legal or medical advice.
I have watched hundreds of people navigate Worker’s Compensation. I am not going to say what people should do in these cases, just relay some of my impressions. Keep this part in mind as we discuss this issue; Your employer was required by law to pay those premiums for coverage. Now it’s time for the insurance company to honor their obligations.
Most are not faking…some are
Sometimes the connotation of that word is negative, or it is associated with a faked injury. In my experience, most people want or need to go back to work as quickly as possible. Most cases are due to a legitimate injury at work.
I have witnessed some cases (maybe 1%?) that are faking their injury. This is extremely hard to do. Unless you are Robert DeNiro in Awakenings, it is very hard to fool people who watch injury patterns all day, everyday. You deserve an Oscar for that performance if you can pull it off.
You have to successfully fake this injury pattern for hours in rehab, week after week. Some people forget to fake it in the parking lot before they walk in. Some buildings have these things called windows. Some people forget which side they are faking.
The law is on your side
This is my impression, however most people don’t feel this way. Most of us don’t know how to navigate the legal workings of state or federal law. Best thing I’ve seen is to read the state website and contact those representatives about your legal rights under Worker’s Compensation.
Since most of us don’t know our rights, we think whatever the doctor or case worker says is final. That is not my impression. You do have to follow certain work requirements under the agreements.
I will relay my own state’s specifics, however, your location may be different. In my state, the employer has first choice for medical provider, however after 60 days, the employee may request a different doctor. There is also a way to file disputes through the state agency.
Get your act together
Some of these injuries can be chronically painful and stressful. People are angry about their situation, and justifiably.
But taking it out on the case manager usually does not help. Best thing I have seen from others is to dress and act professionally. Learn the state laws protecting you. Be armed with information. Call the case managers repeatedly, yet in a professional manner. If you are not at work, and not getting help, consider driving to the state department in person to get assistance with your case. The insurance company is not concerned with an angry employee, but they are concerned with an informed employee.
It’s not over until you quit or agree
I have witnessed injured employees with a severe debilitating injury, yet they also had nerves of steel. They were not going to allow the insurance company to low ball them, cut them off from services, or agree to settlements that were unfair. I’m not taking about cases where someone was looking to make money. I’m talking about people who were protecting themselves from a medical and insurance industry.
I met one guy who’s insurance claims are still going on after 20 years. He’s not bitterly angry and yelling at them. And he’s not faking it either. His spine is a mess from some structure falling on him. He is a very pleasant smiling person. But he knew his medical needs over his lifetime were far more expensive than the settlement the insurance company was offering. They just want him to accept and settle, so they can wash their hands of it.
Arm yourself with information, and protect yourself from the industry. Make them help you the way they are legally required to.