Reasons a workers’ compensation claim can be denied

Workers’ compensation is designed to protect those people who have been injured while on the job. When a worker is injured and files a compensation claim, he hopes that it will have a positive outcome, he hopes that medical treatment and monetary compensation will help improve his health and quality of life.

Unfortunately, just filing a claim does not guarantee that it will be accepted, the reality is that many claims are denied.

The following list contains the most common reasons why a compensation claim may be denied.

  • Unrelated Injuries: The insurance company may argue that this injury is not work related or occurs outside of work hours and is therefore not compensable. If this is the case, you may need to provide evidence that your injury is work related.
  • Disputes: Your employee may want to dispute the claim. This may be because they feel the injury is due to his negligence or behavior, they may also want to avoid paying for insurance.
  • Delayed Processing: One of the most common reasons for denial is that the injury or illness was not reported within the first 30 days. You may still be able to get benefits if you file late, but it’s best to talk to a lawyer as soon as possible to avoid additional complications.
  • Lack of Treatment: Claims may be denied because the injured worker did not receive medical treatment for the illness or injury. This is because injured workers are expected to receive treatment in order to qualify for workers’ compensation claims.

If you are filing a workers’ compensation claim and are looking to get your claim accepted, having an experienced attorney is a must.

Having a professional who knows the process can help you increase your chances of success in court.

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