What does controverted mean?
Generally, the workers’ compensation defenses boil down to a few things:
- The work accident did not happen or there is no insurance coverage;
- If the accident did happen, the injury was not severe; or the injured worker’s misconduct caused the injury;
- If the injured worker is disabled, the disability is not caused by a work accident;
- The injured worker is a bad person and should not be believed.
If the insurance company believes it can advance one of these defenses, it should be formally contested or liability denied by filing a “controvert.” Literally “deny the truth” of the claim. A controvert is evidenced by filing the State Board Form WC-3. This filing gives all the parties of interest notice that the insurance company contests its responsibility and will refuse to pay unless ordered to do so by an ALJ. If you receive a State Board Form WC-3, it means that the insurance company is digging its heels in the sand and is daring you to retain a lawyer.
If the insurance company cannot deploy one of the above defenses, it will generally employ the legal maximum of “Justice delayed is justice denied.” Here, the insurance company will not formally deny or controvert the injured workers’ benefits but it will move at a snail’s pace under the disguise or pretense of “investigation.” While there are some time frames outlined in the law, they are largely ignored by the State Board and a tremendous amount of leniency (and deference) is given to the insurance companies.
If the insurance company is taking several weeks or months to approve your medical treatment with the insurance doctor it directed you to see, then the adjuster is hoping that you will simply give up. The adjuster will likely be extremely rude to you or attempt to make you feel like you are a bad person for getting injured on the job.
Call Our Workers’ Compensation Experts today!
Fight against these insurance tactics. You deserve medical care and income benefits if you were hurt at work. Don’t go at it alone. Call the Ramos Law Firm today.