What if an employer questions the origins of a work injury?

Every job comes with a degree of risk, as workers can sustain injuries or develop illnesses because of their employment. The workers’ compensation program protects employees from job hazards damaging their health and finances. Should a worker get hurt on the job or acquire a job-related medical challenge, workers’ compensation can help them.

Medical benefits can pay for all of the worker’s necessary treatment costs. They can also replace a portion of their wages using disability benefits. Companies benefit, as the coverage they carry indemnifies them from direct legal and financial responsibility for worker injuries. Most of the time, workers and the companies that employ them cooperate during workers’ compensation claims. The employer acknowledges the injury, provides accommodations and helps keep the worker on the job if possible. Occasionally, disputes arise. The employer may try to claim that the workers medical issue is not the result of their employment but an outside cause.

How should employees clarify the origins of their injuries to get the benefits that they need?

Testing can help strengthen a worker’s benefits claim

Workers may need to undergo a specialized evaluation. In scenarios where there are disputes about a workers’ compensation claim, medical review is often necessary. The state authorizes licensed health care professionals to act as qualified medical evaluators (QMEs).

Typically, the injured employee can select a QME from a list provided by the state at random. They must then attend a multi-hour evaluation. A QME conducts multiple tests to look at the extent of the injury and the way it may impact a worker’s job performance.

They can also potentially reach conclusions regarding the origins of the injury and what job tasks may exacerbate the issue. Workers are often subject to observation from the moment they arrive at the facility for evaluation. The QME may watch them enter the building and handle paperwork before the actual evaluation even begins.

A QME’s determination can validate a worker’s claim that their job is the reason for their medical challenges. Their report can lead to benefits and can help the worker get on-the-job accommodations as well.

Those facing disputes with their employers during workers’ compensation claims often need help. Learning more about how to resolve different types of disagreements can help workers get the benefits they need.