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Iowa Work Comp: Should you report the injury as non-work related?


Blog Category:
9/23/2013
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The Rule: Never LIE! If it is a work related claim then report it as a workers’ compensation claim.

Asked by the employer to lie about the injury being non-work related the tale soon blows up in this injured workers face tripping up not just her workers’ compensation claim but also with her health insurance.

Question: Can I sue my employer for making me lie?

Question Detail: I recently slipped and fell off a roof at work. I landed on my head and my knee. In the fall I suffered a concussion and damage to a knee that is not going away or healing quickly. My employer had asked me to lie about where it happened because he does not have worker's compensation insurance, now he is saying that he is going to fire me. I have been out of work now for a week and I don't know if I can do roofing anymore because of my knee, can I sue my employer for this?

Answer: I get asked this question far too often. I’m usually asked to get involved long after the employee has agreed and by then the supervisor or employee denies they asked the employee to lie about the injury being non-work related. And that’s the most important part of today’s blog. Don’t lie because when you are out of work, there is no money coming in and now you have no insurance coverage for the medical expense, there is no easy or sure answer to get coverage.

Anyone thinking of doing this should just shoot themselves in the foot because lying to the health insurance company to get coverage hardly ever works out like you think it will. When you don't follow the rules for accurately reporting a claim, these things never work out as you would think they would. Consider for a minute what you will tell the doctor in the history? Are you intending to mispreport the injury to your doctor? No. Okay, so as soon as the doctor hears your description he will report the injury on a form to BCBS and they will reject the claim as a work injury. 

Then what? Then you go back to the workers' compensation insurance and they reject the claim because you said initially the injury didn't happen at work. Now you have no coverage. 

So what should you do?

First, report a workers’ compensation claim like you should. File the workers' compensation claim with your employer and then if he refuses to accept the claim, then report him to the Iowa Industrial Commission for not having insurance. That should get the ball rolling. Then call me. 

And I'm not inviting everyone who hasn't told the truth to call my office. I'm talking about those clients who do report their claims accurately - yes, you, you are the one's I want for the bulk of my practice. I'm not trying to make my life miserable with misreported claims. 

So what does happen after you have followed the supervisor's advice and misreported the claim?

Let us consider what you’ve done - You need to recognize before trying to do the end-run on your health insurance carrier that you have created the impression you, not the supervisor or employer are the liar. By lying you compound the problem of not having coverage. If it is a work related claim then report it as a workers’ compensation claim. You see the supervisor's all deny they were the one's telling you to lie. It's a setup to make you look like a liar and to destroy your credibility. So don't do it.

If properly reported but not covered because the employer failed to insure, then the claim can then be covered by your health insurance, Medicaid or some state aid program. By lying to your health insurer you are the liar and you are the one no one wants to help.

So don’t lie, tell the truth and to hell with your boss, if he’s not smart enough to know the risks of injury to roofers and buying the right insurance to cover them, then maybe he shouldn’t be in business. 



Category: Workers' Compensation & Employee Rights


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