Notorious Reasons Workers Compensation Claims Get Denied

  • Posted on: May 1 2018
  • By:

Employees have the liberty to file for worker’s compensation claims, but unfortunately it’s not a surety that they will be paid.

As employees go about their daily duties at work, they may get injured or develop a medical condition as a result of the job. These kinds of employees always hope that they qualify for the worker’s compensation claims. That’s not always the case. The compensation claims end up being denied due to a wide range of factors. Read on to find out more.

  1. Delay in reporting the injury

A worker’s compensation process typically begins once the injured worker notifies his/her employer. Failure to tell your employer about the injury in a timely manner absolves the employer from any legal requirement to initiate the claims process. The only time when an employer would have to report a worker’s injury to their insurer is when this injury reduces an employee’s full wages for at least 5 days. It is your responsibility to alert your employer about an injury. Do not make the assumption that the employer has already seen it or knows about your state. In fact, it is better to issue a written notice.

  1. Reporting your injury to the wrong people

This is a common mistake by most employees. Once they are hurt, they are quick to tell their doctors about the work’s injury but do not do the same with their insurer or employer. Your claim is greatly undermined if you do not report it to the right people. If you wait until your doctor suggests a surgery for you to report an injury, your insurer may be suspicious of the claim and deny it.

  1. Injury didn’t take place at work

You have been insured against work injuries. An injury that takes place while you were doing anything else rather than your job duties won’t be compensated. You do not necessarily have to be at your jobsite for you to receive your claim. Individuals who get injured while on a job assignment elsewhere have a claim.

  1. Got injured while intoxicated

Accidents that happen while you were intoxicated are typically not compensated. While being taken to a doctor for a work injury, you may often be required to test for alcohol or drug use. If it is found that you were under the influence of drugs, the claim gets canceled altogether.

  1. Non-medical provider treated you

The worker’s compensation system empowers your insurance company to give you a list of doctors from whom to receive treatment. Deviating from this list with no justifiable reason puts your compensation claims in jeopardy.

It is not a guarantee that getting injured at work makes you qualify for compensation claims. Understand all the rules involved to increase your chances of getting compensated.

Posted in: Blog, Workers Compensation Benefits

3 Convenient Locations



Recent Posts

What Is Tennis Elbow?

Many people have heard of tennis elbow, but few people really understand what it is. Many also assume you can only get it from playing tennis, but that is not true at all. In fact, many people who work in an office, in trade jobs, or even in supermarkets and other establishments are often diagnosed ... read more
  • Posted on Mar 29, 2021
  • By:

Should I See a Workers’ Comp Doctor if I’ve Seen My Primary Physician?

If you were involved in an injury at work that didn’t require an ambulance or even a trip to the ER, you may have booked an appointment with your primary care physician for an evaluation. It’s always a good idea to see a doctor after being hurt while on the job, even if you don’t ... read more
  • Posted on Mar 15, 2021
  • By:

Ride-Sharing Services and Auto Accidents: What You Need to Know

Ride-sharing services such as Uber and Lyft are very convenient and affordable, and many people use them every day. But what happens if your driver gets in an auto accident while you’re a passenger? If you’ve been in such an accident, you need to know what to do to ensure that you receive the compensation ... read more
  • Posted on Feb 26, 2021
  • By:

Get in touch