What Does It Mean When Virginia Workers’ Compensation Claims Are Investigated?

Workers in Virginia who sustain injuries while on the job should be entitled to obtain compensation from the state. While these perks are appealing, they are not always straightforward to achieve. It’s in the insurance industry’s best interest to turn a profit. They frequently attempt to minimise, delay, or outright deny compensation. One tactic they use is to tell hurt employees their grievances are “under review.”

Until a determination is made on an employee’s claim, the insurance company may refuse to pay for treatment or may pay only a fraction of the total cost. A workers’ compensation attorney at Injured Workers Law Firm in Virginia can assist injured workers during the inquiry process and fight the insurance company’s efforts to withhold benefits.

Some workers’ comp claims are looked into because of the reasons above.

There is no set time during which an investigation of a workers’ compensation claim cannot be conducted. While investigations can occur at any point in the claims process, they typically begin soon after an employee reports an accident and injury to their employer. If the insurance company has reason to believe the employee is attempting to defraud the employer out of workers’ compensation funds, it will initiate an inquiry.

When investigating a claim, insurance companies often question whether or not the business itself committed fraud. For instance, a company may unlawfully withhold disability payments or retaliate against workers who have sought compensation under the Workers’ Compensation Act or who have offered statements or testimony in support of a claim made by a coworker.

When a claim is filed for workers’ compensation, what steps are taken?

When looking into a worker’s compensation claim, an insurance company may do a number of different things. In order to keep tabs on the wounded worker, the insurer may hire a private investigator or assign one of its own adjusters to shadow the person. The insurance company’s goal at this stage is to uncover evidence suggesting the injured worker’s injuries are less severe than they initially claimed.

Accident reconstructionists may be consulted by the insurance company as well. Experts in this field can look at everything that was found, reconstruct what happened, and say for sure whether or not the worker’s injuries would have been consistent with what happened.

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