Workers’ compensation and case-shifting

On Behalf of O’Malley Tunstall PLLC | Mar 22, 2016 | Workers’ Compensation

When workers in North Carolina suffer an on-the-job injury, they should be entitled to workers’ compensation benefits. Certain types of workplace injuries, such as fractures, are easily traced to the workplace. Others, however, may be more difficult to show that they resulted from work.

According to Business Insurance, doctors may tend to attribute injuries, such as soft tissue injuries, to a person’s job. The workers’ compensation insurance industry calls this practice case-shifting since it moves the responsibility for payment from the injured worker’s own health insurance to their employer’s workers’ compensation insurance. The industry claims doctors do this because they receive higher payments from workers’ compensation than they do from regular health insurance.

This gives injured people an idea of some of the types of claims employers and their workers’ compensation insurance carriers may try to make in disputing an employee’s application for benefits. Even though an injury came from a person’s performing occupational tasks, an employer may try to deny that simply to keep its costs lower.

Those who have been injured on the job may want to get help from a workers’ compensation attorney when preparing and filing the required claim for benefits. The benefits that could be available might include the furnishing of necessary medical care and treatment as well as a replacement of a percentage of the worker’s wages that were lost during the recovery period. An attorney can also often be of assistance in representing the injured worker in a subsquent appeals hearing if the claim is initially disputed or denied by the employer or its insurance carrier.