I've had a few claims of WC in the past. I also spent 18 years as a WC and road accident investigator. So I know the industry well in all areas including fraud, genuine claims and the "animal" the system is and why it is an "animal".
"Animal" meaning the WC system has evolved over time to become an unfair system on genuine claimants. The reason (although not necessarily justified) is that the claim rates are very high per employee numbers brought about by those that over state their symptoms and see it as a way of earning vast amounts of income from eventual pay outs from a court for damages, rather than swap professions or work with the (flexible and compassionate) employer, if that was the case.
The result of this excessive claim rate and subsequent huge pay outs has downloaded to very high WC premiums for employers. The more claims the higher the premiums. Even so, the average employer especially large ones dont care- you become just a number on the scrap heap and that shows clearly with lack of eagerness to assist you.
All this results in a difficult experience for claimants, genuine or not, you are all in the same basket. Little wonder once a case arrived on my desk I knew the insurer wanted a result that pointed to fraud rather than a accurate and fair assessment. I cant say anymore about that.
So what can you do? Well it varies from state to state but if your claim is denied (common but not always) that doesnt mean they are not liable. But it does mean that you have an automatic hurdle in that you need to take private legal action to demand compensation or any other action including seeking records for any defence you need. This is where people go wrong, by not commissioning a WC solicitor you are depriving yourself of representation that is crucial to fighting for your rights. Yes, your rights arent automatic. The WC road is a difficult one to navigate on your own and the insurance company has their own responsibility to- keep costs as low as possible, prove fraudulent claims for what they are, prove the capability of the claimant compared to their claim and make profit.
Taking leave instead of making a claim is commendable but that doesnt mean it has serve you better. Honourable actions dont mean you'll be rewarded in this world and you wont be able to refer back to your leave periods as being due to a workplace injury.
So, thats the system, the "animal" the reason it doesnt reward genuine claimants with genuine help.