Most employers are required to participate in the Vermont Workers Compensation program, which is a type of insurance that pays benefits to employees who are injured on the job or develop a work-related illness. Sometimes the insurer questions or outright denies a claim, which can be very frustrating to the person waiting to receive benefits. Insurance companies may do this if they believe there is a distinct possibility of fraud.
Reasons for Skepticism
An injured person may feel insulted at any suspicion that he is faking the injury or its effects in an attempt to obtain Vermont Workers Compensation. However, fraudulent claims are just common enough that insurers are careful to investigate if they believe there is cause to be skeptical.
Examples of Fraud
For instance, in a behavior known as malingering, the person pretends that the serious effects of the injury continue even after she is actually well enough to return to work. Another example is when the individual takes on casual part-time work for cash, hoping this will not cause problems. The laws about this are complex, but in general, the claimant can only work while receiving workers comp if he has been approved for light duty activity. All earned income, even cash, must be reported to the primary employer or the insurance company paying benefits. Otherwise, insurers and the law consider this to be fraud.
Responsibility
The employer or insurer may dispute the case if they believe the worker was responsible for the injury. However, the worker often is allowed to receive benefits even when this is the case. For instance, trying to fix a machine without shutting it off first can cause serious harm to fingers, but workers comp benefits still usually are paid.
How Lawyers Help
When someone is having trouble getting approval for workers comp benefits or the payments have been stopped prematurely, professional legal representation from a firm such as McVeigh Skiff LLP can help. An attorney makes sure all future paperwork is filed correctly and that the representatives receive all medical documentation and other evidence they need to support the case. This lawyer also will represent the client at any hearings that are scheduled.
