Common Workers’ Comp Disputes and How to Handle Them
Filing for workers’ compensation after a job-related injury should be straightforward, but unfortunately, many workers encounter disputes that delay or reduce their benefits. At Wood & Carlton, P.C., with offices in Corinth, Tupelo, and Pontotoc, Mississippi, we’ve helped countless injured workers resolve disputes and secure the compensation they deserve.
In this guide, we explain the most common workers’ comp disputes, why they happen, and how to handle them effectively to protect your rights.
Why Workers’ Comp Claims Get Denied
The first and most frustrating dispute many workers face is a claim denial. Mississippi law requires employers and insurance companies to act in good faith, but denials are still common. Reasons for denial include:
Lack of Medical Evidence:
If your claim lacks clear documentation showing that your injury is work-related and serious, it may be denied.
Missed Deadlines:
Failing to report your injury within 30 days or file a claim within the two-year statute of limitations can lead to automatic denial.
Disputes Over Work-Relatedness:
The insurer may argue that your injury did not occur at work or was caused by a pre-existing condition.
Employer Challenges:
Sometimes, employers dispute the facts of your injury, claiming it happened off the clock or was the result of misconduct.
Failure to Follow Medical Advice:
If you skip appointments or don’t follow your doctor’s treatment plan, your benefits may be denied or suspended.
At Wood & Carlton, P.C., we know how to investigate denials and build strong appeals to overturn unfair decisions.
Disputes Over Medical Treatment
Even after your claim is accepted, disputes over medical treatment are common. These include:
Treatment Denials:
The insurer may refuse to authorize certain treatments, arguing that they are not medically necessary.
Doctor Disagreements:
Your treating physician may recommend a course of action, but the insurance company’s independent medical examiner (IME) may disagree.
Switching Physicians:
Mississippi law allows you to choose your own doctor after the initial visit, but disputes can arise if the insurer challenges your choice or refuses payment.
Delayed Care:
Even if treatment is approved, delays in scheduling appointments or procedures can stall your recovery.
Our attorneys work closely with medical providers to ensure your treatment is authorized and delivered without unnecessary obstacles.
Disputes Over Work Capacity and Light Duty Assignments
Returning to work after an injury can also create disputes, especially when it involves light duty work. Common issues include:
Disagreement on Ability to Work:
Your doctor may say you can only return to light duty, but the employer may disagree or insist you return to full duties too soon.
Lack of Suitable Work:
If your employer cannot offer light duty, you may be entitled to continued wage benefits. However, disputes arise when employers claim that light duty is available—even if it’s not reasonable.
Forced Return to Work:
In some cases, injured workers feel pressured to return before they are medically ready, risking re-injury.
It’s crucial to have clear, written medical restrictions. We help enforce your rights and challenge inappropriate work assignments.
Appealing a Denied Claim
If your workers’ comp claim is denied, you have the right to appeal through the Mississippi Workers’ Compensation Commission (MWCC). The process typically involves:
1. Requesting a Hearing:
You or your attorney must file a formal petition for a hearing before an Administrative Judge at the MWCC.
2. Discovery Phase:
Both sides exchange medical records, employment history, and other evidence.
3. Mediation (Optional):
Some cases may resolve through mediation before a formal hearing.
4. Formal Hearing:
A judge hears testimony from you, your employer, doctors, and other witnesses. After reviewing the evidence, the judge issues a decision.
5. Appeals:
If you disagree with the judge’s decision, you can appeal to the full Workers’ Compensation Commission and, if needed, further appeal to the state courts.
We manage every step of the appeals process, ensuring your case is thoroughly prepared and aggressively represented.
Mediation and Hearings in Mississippi
Mississippi encourages the use of mediation to resolve disputes without a formal hearing. Mediation is a voluntary process where both parties, with the help of a neutral mediator, work toward a resolution.
Advantages of mediation:
- Faster resolution compared to formal hearings
- Less stressful and more collaborative
- Often more cost-effective
If mediation fails, your case proceeds to a formal hearing. At Wood & Carlton, P.C., we prepare every case as though it’s going to trial, ensuring we are ready for all possible outcomes.
Tips for Protecting Your Rights During a Dispute
To strengthen your position during a dispute, follow these best practices:
Keep Detailed Records:
Document every aspect of your injury, including dates, conversations, and medical visits.
Follow Your Doctor’s Orders:
Compliance with medical advice helps prove the seriousness of your condition.
Communicate Promptly:
Respond quickly to requests from your employer, insurer, or attorney.
Get Legal Help Early:
The sooner you involve an attorney, the better your chances of a successful outcome.
Why Choose Wood & Carlton, P.C.?
At Wood & Carlton, P.C., we have extensive experience handling all types of workers’ compensation disputes. We provide:
- Free case evaluations
- No upfront fees—you pay only if we win
- Aggressive advocacy for denied or delayed claims
- Personalized support at every stage
Our offices in Corinth, Tupelo, and Pontotoc are dedicated to protecting the rights of injured workers across Mississippi and western Tennessee.
Contact Us for Help With Your Workers’ Comp Dispute
If you are facing a workers’ comp dispute, don’t fight it alone. Contact Wood & Carlton, P.C. today for a free consultation. We are ready to stand by your side and fight for the benefits you deserve.
