When the Permanence of a Workplace Injury is Disputed

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While suffering a workplace injury is always going to be a highly unpleasant ordeal, you will of course hope that your injuries will be minor, allowing you to return to your employment after sufficient recuperation. Unfortunately, this is not always the case. If the nature of the injury is particularly severe, you might be facing the prospect of a permanent impairment, effectively rendering you unable to return to your employment at any stage in the future. Generally such a classification is clear; agreed to by both yourself and the insurance provider acting on behalf of your employer, allowing you to receive permanent ongoing workers compensation. But what about when the permanence of the injury is in dispute?

Lodging a Request for a Review

When the insurance company wishes to dispute the permanent nature of your condition, naturally you will need to lodge a formal request that their decision is reviewed. This will generally need to be done in writing (and this then creates a record of each subsequent step of the process, which is necessary in the event of escalation). You will receive a list of reasons for their decision which might be a point-by-point assessment of the severity of your injuries, along with the potential for recovery as deemed possible by the examining medical professional.

Further Medical Assessments

In order to counter the reasons for the decision, another medical assessment might prove to be necessary. It's important to do so as soon as possible so that you can receive the results of any requested tests in case the matter goes to arbitration. You might also wish to consult your own GP so that they can provide you with a comparative report, detailing your general health prior to and after the accident. You will then provide this new information to the insurance company and request a review, taking this new information into account.

Formal Arbitration

If the insurance provider still disputes the permanence of your injury, you will need to request a formal arbitration, overseen by the Worker's Compensation Commission (or other applicable official body) in your state or territory. There might be the need for a further medical examination by a specialist appointed by the commission. This allows for a neutral pair of eyes to undertake the assessment, as opposed to a medical professional utilised by either you or the insurance company. There's no guarantee that the commission will rule in your favour, and yet it's a formal way to resolve such a dispute if it can't be worked out between you and the insurer.

A potentially permanent impairment can be difficult enough to deal with, so it's good to know that there's a resolution process in place if the permanence of your injury was to be disputed.

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11 September 2017

Carl's Commercial Liability Insurance Blog

Hi, my name is Carl and this is my blog which is going to deal with a very important subject. I am not own a business but I sometimes used to help my brother out with his local business supply company. One day, when I was helping to sort out the paperwork at the end of the year, I found a document detailing the commercial liability insurance policy for the business. I asked my brother to explain what it was and he did. Since then, I have become very interested in all kinds of commercial insurance and I decided to start a blog to explore the subject further.