The Evidence You’ll Need to Back a Workers’ Compensation Claim

Posted in Uncategorized on June 20, 2017.

The Alabama State Workers’ Compensation system protects workers who are injured or who suffer employment-related diseases by allowing them to obtain the medical care they need, appropriate rehabilitation, and a percentage of their lost earnings, without having to prove anyone to be negligent, and without having to go through a long, drawn-out legal process. Our Birmingham, AL workers’ compensation attorneys break down the evidence you’ll need. 

In most cases, if you have been injured in the course of your employment, you will have to prove only a few things:

  1. That you suffered an actual injury or disease;
  2. That you had an employment relationship with your employer (as opposed to, for example, being an independent contractor), and your employer was required to cover you under the state Workers’ Comp law (non-agricultural work with five or more employees);
  3. That your injury, or exacerbation of an ongoing condition, occurred in the course of your employment;
  4. That the disease, injury, or exacerbation was directly related to the performance of your job and not caused by some accident or medical condition that occurred outside the job (except in the case of a work-related exacerbation of another condition), and
  5. That you reported the accident or illness to your employer in a timely manner.

The benefit: you don’t have to sue anyone to get benefits. But, there is a tradeoff: even if your employer’s negligence caused your injury, you can’t sue the company for your damages. And Workers’ Compensation does not compensate you for pain and suffering or other non-economic damages.

Making Your Claim

  1. Report your accident to your employer within five days. If you wait longer than 90 days, you may lose your right to receive benefits. Your written and signed report should include:
  • Date and time of the accident
  • Where and how it occurred
  • The nature of the injury and the symptoms you are experiencing
  1. See the doctor whose name has been provided by your employer, usually from a list.
  2. Give the doctor an honest assessment of your symptoms, without exaggerating or withholding information.

Your report and your medical records will form the basis of your claim. Lost earnings will be computed based on your average weekly earnings as determined by pay stubs or payroll records.

If Your Claim is Denied

In most cases, you should be approved for benefits with the information itemized above. But it is possible your employer may deny your claim, in which case you may have to provide additional evidence to prove your eligibility in the appeals process. In this case, you may do well to hire a Workers’ Compensation attorney to represent you. Your employer may be claiming that you do not qualify based on one of these potential reasons:

  • You were not injured while engaged in your employment.
  • No employer/employee relationship existed at the time of the accident.
  • Your willful misconduct was the cause of the accident.
  • You were injured due to your impairment by alcohol or drugs.
  • A third party or another employee caused your injury for personal reasons that were not related to your work.
  • Your injury was the result of your deliberate attempt to harm yourself or another person.
  • You knowingly ignored a company rule or regulation or failed to follow company safety procedures or use safety equipment your employer made available.
  • You failed to report the accident or injury to your employer.

In order to prove your claim, your attorney will need to obtain:

    • Any available accident reports, including your report of the accident to your employer and any police report, if there was one;
    • Your medical records to prove your injuries; 
    • Your employment records, to establish the employer/employee relationship and your earnings;
    • Names and contact information for anyone who witnessed the accident;
    • Any photographs or video footage of the accident, of the area in which it occurred, or of the piece of equipment that was involved;

 

  • Testimony of expert witnesses, which might include accident reconstruction experts, industrial engineers, doctors, psychologists, physical and occupational therapists, and others.

 

Your Birmingham injury attorney will investigate the circumstances of the injury or illness underlying the claim, gather all appropriate evidence to prove its validity, and develop a strategy to give you the greatest likelihood of success in the pursuit of benefits. In addition, your lawyer will determine if any third party was partially responsible for your injury. If so, you may have an additional civil claim against that party, which you will be able to pursue just like any regular personal injury claim, with a lawsuit when necessary. You may recover damages for pain and suffering and quality-of-life damages in a third-party action, and thus recover more money than you would be eligible for in a Workers’ Compensation claim alone.