My Employer Won’t Pay My Workers Comp Claim

If your employer won’t pay your workers comp claim, consider hiring an attorney who specializes in these kinds of claims.

At Cassis Law, we typically don’t handle workers comp claims because we prefer to focus on employment law. But there are times when a workers comp claim should be referred to an employment lawyer. Here’s how this often works.

An employer is required by law to have workers compensation insurance that covers any employee in the event of a workplace accident or injury.

Broken leg in castOftentimes, small companies don’t carry workers compensation insurance because of the cost. If an employee gets hurt, the employer has no way of covering it. The employee can call the state workers compensation commission, which will conduct an investigation. However, the commission can only punish the employer; the employee still has to figure out how to pay for medical treatment.

Another, more common scenario is when an employee gets hurt on the job, but the employer doesn’t want to report the incident to his workers comp insurance company. the employer may try to sidestep the situation by telling the employee to just go to the doctor and put it on his or her own health insurance. This could be illegal in some situations.

The correct procedure is to turn the employee’s claim in to the workers comp insurance company. The company will handle the claim, so the employer can’t really deny or stop it in the first place. The insurance company will then decide if they are going to pay or not, while the employer is just a witness. However, the employer can give some insight into the situation. For example, an employee could claim he got injured at work when he really got hurt at home. If the employer has knowledge of this, they can tell the insurance company. Ultimately it is up to the insurance company to make the final decision.

Employers often do not like filing workers comp claims, because they drive up insurance premiums and rates. It could also affect scheduling, because the employee needs time off to go to the doctor, or ask for light duty work, which can decrease productivity. These all add costs and extra work to the employer, which can be an administrative nightmare. The employer may get upset with the hurt employee and fire them in retaliation.

When that happens, an employment lawyer would get involved under the workers compensation retaliation statute, KRS 342.197. This states that it is illegal for an employer to fire an employee because that employee filed a workers comp claim. Since it’s illegal for an employer to retaliate against an employee for things like whistle blowing, reporting discrimination or sexual harassment, or making a workers comp claim, this becomes an employment law case.

Any time an employer retaliates against an employee, such as firing them for making a workers comp claim, that employee can file suit against their former employer. If this has happened to you, please contact the Cassis Law Office at (502) 736-8100.


Photo credit: Ted Eytan (Flickr, Creative Commons)