What Makes a Valid Workers’ Comp Claim?

  • Posted on: Sep 25 2018
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Filing a worker’s comp claim is fairly standard if you’ve been injured on the job, but your claim may be denied if it’s found to be invalid. Sometimes a claim is determined to be invalid, not because it truly is but because the employee failed to include all of the right paperwork and other information. While the denial may be able to be appealed, that does mean you have to go longer without any form of compensation. This can make things financially difficult, so it’s always best to make certain your claim is fully valid when you file it. Here are the things you’ll need to make a valid worker’s comp claim.

You Reported the Incident to Your Employer

You need to report any accident, especially one where you or someone else was injured, to your employer as soon as possible. If you don’t make a report, your claim may not be valid. Reporting an accident several days, weeks, or even months later may also invalidate your claim.

Your Employer Must Have Workers’ Comp Insurance

In most cases, this isn’t an issue. However, some businesses may have tried to avoid paying for workers’ comp insurance or may have put off getting it. For example, if you’re the first employee to be hired by an LLC or sole proprietorship, the business may not have been required to have worker’s comp insurance. The owner may not have purchased a policy yet, which means you wouldn’t be covered.

You’re Classified as an Employee

Another issue you may face that could invalidate your claim is if you’re not technically classified as an employee. If you’re a consultant, contractor, or a freelancer, for example, you may not be covered by a workers’ comp policy regardless of where the accident occurred. However, some policies do cover contractors. It depends on the policy, the state regulations, and, at times, the decision of the court.

You Can Prove Your Injury or Illness Is a Direct Result of Your Work

This can be easy or difficult to prove. It all depends on the nature of your injury. For example, if a large box fell on you while working in a warehouse, it’s a fairly obvious workers’ comp case. If you developed a hernia and first had it diagnosed on the weekend, it’s not as clear. Your work could easily have caused it, but so could one of your hobbies.

The experts here at Maximum Orthopedics can assist you with determining the validity of your workers’ comp claims. Contact us today to discuss your case.

Posted in: Blog, Work Injuries, Workers Compensation Benefits

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