Five Common Misconceptions About Alabama Workers’ Compensation

Jan 8, 2016 - Tuscaloosa, Workers' Compensation/Work Injury by

Alabama workers’ compensation provides essential benefits for injured workers, but depending on the nature of a given claim, it may not always work exactly as expected. Every situation is unique, so employees cannot always assume that they know the rules.

Five Rules That Are Not as Simple as They Seem

The Alabama Department of Commerce created the Unemployment and Workers’ Compensation Manual in an attempt to simplify the state’s employment-related laws. However, the actual rules contain legal language that includes many details and exceptions. The following five misconceptions are among the ones that commonly affect claims:

  • Part-time and contract workers do not qualify for coverage. Not true for part-time workers, but probably true for contractors. With some exceptions, the Alabama workers’ compensation system considers full and part-time workers to be employees, and businesses that have five or more employees must carry coverage.

    Contract employees should be covered under their own employers’ workers’ compensation policies when working for a business under a lease agreement, and independent contractors may not have any coverage. Any contractor who is uncertain about coverage should seek guidance from our experienced Tuscaloosa workers’ compensation lawyers who can advise them on their legal options for getting coverage.

  • The right to privacy in workers’ compensation claims is the same as for any other health care situation. Not generally true. To determine benefits and the validity of claims, employers and their insurance companies generally need access to private information about a claimant’s injuries and past medical history. Still, requests for information need to be relevant to specific claims. Claimants who believe the request for information has gone too far may want to talk with a knowledgeable attorney.
  • Injured workers can choose their own healthcare providers. Only in an emergency. In most cases, the employer or insurance carrier selects the physician. If injured workers are dissatisfied with treatment, their employers must provide a choice of four other physicians upon the workers’ requests. Workers who do not reasonably comply with the physician selection rules essentially forfeit their right to benefits, at least for the time period of their refusal.
  • Injured workers approved for workers’ compensation can file additional claims for future accident-related medical issues. True up to a point. Future claims can be denied if there is not enough evidence that the future issues are actually a result of the original workplace injury or illness. Additionally, the claims are limited by the statute of limitations, so they cannot typically be filed beyond two years from the time of the accident or illness. However, there can be occasional exceptions to the statute of limitations, so an attorney can help in some circumstances.
  • Patients pay no out-of-pocket costs for approved claims. Not always true. In most situations, workers’ compensation insurance pays claims in full for medical expenses related to workplace injuries or illnesses. However, employers have the right to monitor physician bills. If the bills are for services when the employer was not notified or if the employer did not approve services, those expenses may not be covered. Similarly, claims for services that do not relate to the covered illness or injury are not covered.

Denied Claims May Require Further Examination

While employers or their insurers may have valid reasons for reducing or denying claims, injured workers should not always accept the denials without further research. When in doubt, it may be time to seek legal support to discuss their issues and learn about possible legal options.

Additional Resources:

Alabama Department of Labor, Frequently Asked Questions.

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