What Every Employee Should Know About Workers Compensation & Arbitration

Posted on: 14 September 2015


Being injured at work typically means that you're eligible to file for workers compensation benefits. However, it's important to understand that filing a workers compensation claim doesn't automatically entitle you to benefits. If you're exploring your options to settle a workers compensation claim, you might want to think about pursuing arbitration. It's often provided as an alternative to court hearings and it may help you settle your case. Here's a look at some of the things you should know about workers compensation and arbitration.

Your Employer's Insurance Company Can Deny Your Claim

Your employer may dispute any injury filing, and that dispute can lead to a denial by the insurance company. There are several reasons why an employer might do this, and one of the most common reasons is to avoid a costly increase in workers compensation premiums. Your employer may look for any opportunity to claim that your injury is not legitimate. Here are a few reasons that your claim may be denied.

  • No Actual Injury—Your employer may try to claim that you aren't really injured. If this happens, you typically can dispute the claim denial with the help of an attorney. This is most effective when you have medical records that clearly detail your injuries and the treatments you received.
  • You Weren't Hurt at Work—Another common reason to deny workers compensation is the claim that you weren't hurt at work. If your employer has any evidence that your injury didn't actually happen at work or as a result of your required duties, he or she can deny the claim. To overcome this, you'll have to prove that the injury happened as you said it did. A workers compensation attorney can help you find the best way to do this based on your case.

Arbitration May Help

Arbitration allows you to negotiate the claim and present your side of the case without having to actually appear in court. During arbitration, a third party is assigned to hear both sides of the situation. The third party is a neutral individual who will then review all of the evidence and documentation to arrive at a determination.

In most states, the arbitrator's settlement recommendation is just that—a recommendation. You have the right to file the case in court if you don't agree with what the arbitrator determines in those cases. In some states, however, the arbitration process is legally binding. This means that you're committed to accept the arbitrator's findings just as you would a judge. Make sure you ask your workers compensation attorney about whether or not arbitration is binding before you agree to it.

You May Be Able to Appeal

If your attorney tells you that you have the legal right to appeal your arbitration finding, you'll have to take the case to court. In situations like this, it is imperative that you have an attorney to help you draft the paperwork and ensure that your claim is comprehensive and well-supported before you file it. Having legal support will help increase the likelihood of your success in court.

In the event that you do appeal, use your experience in the arbitration process to strengthen your case. Think about what things cost you in the settlement according to the explanation from the arbitrator and make sure that you address those issues when you build your case.

Workers compensation cases can take time to settle, and the process can be difficult. This is especially true if you're still recovering from an injury while you're trying to get a settlement. Understanding the reasons why your claim could be denied and how to handle arbitration can take some of the uncertainty out of the process. This may ease your stress and allow you to focus on the claim and your recovery. You can click here for more info and talk to a workers compensation attorney about how you should proceed.