Common Delay Tactics In Workers’ Comp Claims And How To Avoid Them

Workers often depend on workers’ compensation. They use this to recover their lost wages.

Additionally, they also enjoy medical benefits when they are injured on the job. 

However, insurance companies and employers do not always make it easy for injured employees to get their fair benefits.

They sometimes use workers’ comp delay tactics to minimize payouts or cause workers to give up on their compensation entirely.

These delays come in many forms. Firstly, you will have to face slow communication. Then, you will see unending requests for documentation. 

Let’s break down these workers’ comp delay tactics and how to handle them.

Why Do Insurers Delay Workers’ Comp Claims?

Insurers typically delay workers’ comp claims as a result of administrative issues like clerical errors or backlogs. 

Delays may also come up due to ongoing investigations. So, if employers think injuries were not work-related, it may take some time to resolve these claims.

While employers have a responsibility to their workers, these delays are sometimes deliberate, with insurers wasting time to benefit their bottom line. 

By slowing the claims process significantly, they hold onto money for a longer period. 

This way, they collect interest on funds that should have been paid to injured workers. 

Delays can also pressure injured workers into accepting lower settlements, especially when they are desperate. In some cases, insurers stall the process by:

• Disputing medical treatment
• Questioning injuries
• Requesting unnecessary documentation
• Failing to respond promptly

Insurers sometimes waste time with the hope that claimants will become frustrated and abandon the claim. 

Although these workers’ comp delay tactics are unfair, they are quite common in workplaces. 

By determining why insurance companies delay these claims, it becomes easier to identify them.

What Are The 8 Common Workers’ Comp Delay Tactics?

Workers can better defend their rights and access the benefits they deserve if they’re aware of common delay strategies insurers use. 

Workers’ comp adjusters use various techniques to minimize their financial responsibility. Here are the most common ones:

1. Slow Communication

It is a common occurrence for workers’ compensation adjusters to respond slowly during the claims process. 

An adjuster may be flooded with a lot of work if they fail to respond to your calls, emails, or texts. 

However, they may also delay intentionally to break down communication, slow your claim, or frustrate you.

2. Processing Delays

Insurance companies often delay by wasting time when processing workers’ comp claims. 

They may claim that paperwork is missing or slowly move files through the review process. 

These delays cause financial pressure on injured workers, forcing them to settle quickly. 

Processing delays may sometimes occur when injured workers do not report incidents on time.

3. Asking For Recorded Statements

Insurers occasionally request recorded statements from injured employees during workers’ comp claims. 

It is a typical part of the process that seeks to get your version of events. However, insurers do not use this for the claimant’s benefit. 

Instead, they might misread your words and use them against you to reduce your compensation.

4. Delaying Authorization Requests

During workers’ comp claims, insurers may stall approval for medical treatments, specialist referrals, or diagnostic tests. 

They may claim that medical treatments are not needed or covered. This can leave injured workers without timely care. 

Unfortunately, these delays can worsen your health conditions and extend your recovery duration. 

5. Disputing Injuries

In some cases, workers’ compensation adjusters may try to dispute injuries or downplay their severity deliberately to avoid paying benefits. 

They may argue that injuries are not work-related or are a result of pre-existing conditions. 

This tactic might force workers into lengthy disputes, which means the claimant’s benefits will remain on hold.

6. Ordering Repeated Medical Exams

Your employer’s insurance company might order multiple repeated medical examinations to delay your workers’ comp claim. 

While these exams should ideally provide an unbiased opinion about your injuries and the incident, insurers often choose medical practitioners who side with them. 

This way, they can cast doubts on your injury and overall claim.

7. Delaying Payments

Even after claims have been approved, insurance may delay payments. For instance, they might insist that they are waiting for authorization or do not have the funds available to disburse immediately. 

In addition, they may not be willing to pay for certain medical treatments if they deem them unnecessary.

8. Requesting Extra Information And Documentation

Another common workers’ comp claim delay tactic involves insurers requesting more information about your injury or treatment. 

Before your claim goes through, adjusters request details one after the other instead of collecting everything at once. 

Their goal is to spread these requests and increase the duration it takes to process your claim.

How To Avoid Delays In Workers’ Comp Claims

To make the most of your workers’ comp claim, you must try as much as possible to avoid delays. 

You must wrap up the process to get access to funds for your medical bills, lost wages, and other expenses covered by workers’ comp. Here are five ways to avoid these delays:

1. Report Injuries Immediately

By reporting workplace injuries on time, you can avoid delays in your comp claim. Immediate reports create accurate records, hasten investigations, and reduce disputes. 

Fast reporting ensures timely medical care and reduces opportunities for insurers to deny or stall rightful benefits.

2. Handle Paperwork Carefully

By handling paperwork properly in your workers’ comp claim, you can ensure:

• Accuracy
• Completeness
• Timely submission

So, you will have to double-check forms. Additionally, you also need to provide the necessary documentation and follow the filing guidelines. 

You must understand the difference between workers’ comp and personal injury to know what documents to file and how to file them.

3. Communicate And Stay Proactive

If there is clear and consistent communication between employers, doctors, and insurers, the claims process will move smoothly. 

By communicating effectively, you can stay proactive and ensure that all deadlines are met and problems are addressed early enough. 

This reduces misunderstandings, prevents insurers from stalling, and leads to a faster resolution.

4. Keep Detailed Records

Accurate documentation provides clear evidence, prevents disputes, and supports fast claim processing.  Organized records allow injured workers to respond to requests from insurers. 

Overall, it minimizes unnecessary delays, helping you to receive your benefits on time after filing a workers’ comp claim.

Workers’ Comp Delay Tactics Explained

Insurers and employers often capitalize on technicalities to delay workers’ comp claims. 

For instance, they communicate slowly, delay processing and requests, and repeatedly ask for recorded statements and medical exams. 

However, if you report injuries on time and keep records properly, you can prevent these delays.