Reasons Why Workers' Compensation Claims are Denied
(Photo : Reasons Why Workers' Compensation Claims are Denied)

Workers' compensation is designed to protect workers who get injured while on the job or as a result of their work. If you qualify then you will be entitled to obtain certain benefits under the policy of your employer, regardless of who or what caused the injury.

However, obtaining workers' compensation is easier said than done. You may run into obstacles or pitfalls that could cause your claim to fail. Below, we will list some of the most common reasons why workers' compensation claims are denied.

There are No Witnesses

If there were no witnesses present during the incident that caused your injury then your insurer may deny or reject your claim. It can be very hard to prove that you were injured if no witnesses are willing to testify to substantiate your claim.

If you are injured while working you should notify your supervisor or manager as soon as possible. You should also tell your co-workers about what happened, as they may be willing to defend you in the event that your claim is denied.

Take photos and/or video footage as well, as they can be used as evidence to help support your claims in the future.

You Didn't Report Your Injury Immediately

As soon as you are injured you should notify your insurance company. In some cases, this may not be possible, especially if your injuries were so severe that they require hospitalization. However, try to notify them as soon as you can. 

Any delay in reporting may actually hurt your case. The longer you go without reporting your injuries, the less likely it is that your insurer will believe your claim. 

You Were Intoxicated at the Time of the Injury

There are many reasons why an employer may refuse a workers' compensation claim. For example, if you were injured while under the influence of drugs or alcohol then your claim will be denied. 

It is important to be sober while you work, as negligence or intoxication can not only cause grievous harm to you but to your co-workers as well.

Injury Resulting From a Pre-existing Condition

If you were injured before you actually began working at your current employer then you will not be eligible for workers' compensation. An injury that resulted from a pre-existing condition will not be eligible for any form of compensation.

In some cases, an insurance firm may claim that a worker's claim of a current injury is actually pre-existing.

Failed to Provide Medical Records

Your insurance firm will likely verify your medical records. You may feel that such an action is a breach of your privacy but they are within their rights to go over your medical records if you file a claim for workers' compensation.

If you fail to submit all pertinent medical documents and records to your insurance company, then they may reject your claim without investigating further. Please speak to your doctor if you have any doubts or concerns about your medical condition or your medical records.

Failed to Hire a Legal Advisor

If you have been denied workers' compensation then it is not the end. You have the right to continue fighting in order to obtain the justice that you need and deserve. The workers' compensation process can be long and tedious.

You can obtain some help by making an appointment with a professional legal advisor in your area. Many will be more than happy to provide you with a free, no obligation quote and consultation so that you can discuss your needs and concerns without worry.

A legal advisor will increase the chances of your appeal being filed. They will also help enhance the chances that your appeal will be heard.

There is Hope

If you are injured while on the job then you may be dealing with a lot of stress, anxiety, anger, frustration and pain. A work environment is supposed to be a safe place for workers to perform their duties.

As your medical bills begin to pile up you may feel overwhelmed and may feel that you are entitled to compensation for your mental and physical anguish. Filing for workers' compensation is the first step towards obtaining the justice that you deserve.

In the event that your claim is denied, however, you should not give up hope. Speak to a legal advisor in your area, as they may help increase the chances that your appeal will be accepted. 

They will evaluate your case very carefully and will present all the relevant facts in a way that will improve your chances of success. Many will also be willing to provide a free, no obligation consultation as well, so you can focus on your recovery instead of legal bills.