5 Reasons Why a Workers’ Compensation Claim Can Be Denied
After you’ve had a workplace accident, the very last thing you want to hear, is that your workers’ compensation claim has been denied. Unfortunately, it happens all the time. Instead of trying to recuperate and get better, you’re left asking yourself questions about why it was denied, what happened, how you are going to pay your bills – and if it will get fixed.
It’s almost impossible to say why it got denied for sure, but there are common reasons why a compensation claim has been denied.
The Application Was Too Late
Every state in the US has guidelines and deadlines for filing the compensation claim. If you don’t report it on time, you could get denied. There are usually 2 types of deadlines:
– The deadline for you reporting the injury to your employer
– The deadline for filing the compensation claim for your benefits.
If you miss either of these it’s most likely the reason you were denied benefits!
Questionable Accidents
While people get hurt on the job every day, if you don’t have a witness – or even a camera showing what happened, it’s hard to prove that it did happen. If you don’t have any witnesses, the insurance company will be hard-pressed to believe that the accident happened the way you said it did.
It’s important to remember that the insurance companies aren’t working for you – they want to pay out as little money as they possibly can! Because of this, it’s better for credibility, if you did have a witness for your compensation claim.
If you did not have any witnesses you still should be reporting to your boss, manager or supervisor and you should be writing down as much detail as possible. When it happened, where it happened, how it happened, etc. You should also seek medical attention because this is a report that will back up the facts and details you made in the report to your boss.
You Were Liable!
If you were found liable in any way and caused the accident, this will get your compensation claim denied. This means that if you were at your job, or on the clock and were using any substances; drugs or alcohol and they were the reason for your accident, you are at fault – not the company.
Inconsistencies In Your Story
When your story is inconsistent this raises red flags to the insurance companies. For example, if you told your boss one thing and tell your doctor another thing entirely, this could cause a denial in your compensation claim. Make sure that when you are telling your story, that you are being consistent with what you say!
You Didn’t Go To The Doctors
When people are hurt, they usually go to the ER, the hospital or to their doctor. When people are hurt at work, for some reason, they decide to skip medical attention. Not smart! Going to see a doctor when you get hurt at work is going to do 2 things.
1- It shows that you were hurt enough to go to the doctor to get checked out.
2- Everything that happens from the time your doctor sees you until the time you leave the room is going to be documented. This document can and usually will be used as proof to the insurance company – and the employer, that you were hurt, you had these injuries, you were given these treatments/surgeries/instructions and how much everything cost.
If your employer denies the report or does not want to pay for your compensation claim, you can hire a lawyer. When you hire a lawyer, they will collect all the evidence – including the report from the hospital and it will be used in court for your compensation claim.
Worker compensation claims either go really well and everyone gets along nicely and you get the compensation and benefits you need to recoup and get better. Or they go really bad and you have nothing but issues along the way.
If you do have issues, it’s in your best interest to hire a worker compensation lawyer to make sure that your claim is properly prepared and submitted. Not only that but you’ll have someone by your side that will stand up for you and your rights.
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