Five Reasons Why Workers’ Compensation Claims Can be Denied

A claim for workers’ compensation may be rejected by an insurance company for any number of different reasons, which could also impact how much you can get. If your claim for workers’ compensation has been turned down, it is very necessary for you to seek the counsel of a seasoned legal professional in the field.

According to the statistics, there was a rise in the number of rejected applications for workers’ compensation between the years 2013 and 2017. If you have been hurt while working, a competent professional will assist you in preparing for the many difficulties that are still to come. The following is a list of some of the most typical explanations for why applications for workers’ compensation are rejected.

Nobody Was There When Your Accident Occurred

If no one else was there when the accident occurred at your place of employment, obtaining compensation for your injuries will be more challenging. If no one witnessed your injury while you were working, there is not much you can do to improve this area of your case even if you were wounded on the job. Instead, you need to make sure that you disclose your injuries to your employer as soon as possible when they occur. In a similar fashion, you need to make sure that you provide the exact same story to everyone that you speak to about how your accident took place.

You Did Not Immediately Notify Someone Of Your Injuries

If you do not immediately disclose your injuries, you will almost certainly find it much more challenging to acquire workers’ compensation payments. If you do report your injuries, you should do it as soon as possible. If you do not promptly report the accident to your insurance company, they will presume that you were not genuinely injured in the collision.

Discrepancies Between Your Report of the Accident and Your Medical Records

Claims for workers’ compensation are frequently rejected by insurance companies when an employee gives conflicting testimonies regarding the manner in which the accident took place. If you explain the accident to your employer according to one version, but to your doctor according to another, you may have a more difficult time pursuing a claim for compensation after the incident. When explaining the circumstances of the accident that occurred at work to your coworkers, your employer, or medical professionals, be sure to maintain consistency.

You Submitted a Claim After Your Employment Ended

If you wait to make a claim for workers’ compensation until you have been terminated from your job or laid off, your case will have a lot less weight to it. This is due to the fact that many businesses have the mindset that claims being filed are just an act of retaliation. A claim for workers’ compensation should never be delayed for any reason, and this is another one of those reasons. Even if you had a major injury, if you are dismissed before making a claim for compensation, you will have a more difficult time receiving the money that is rightfully yours.

The Medical Condition Was Already Present

Insurance firms prefer to point the finger at pre-existing illnesses when occupational injuries occur. Someone on staff suffered a back injury after falling off a ladder. Do not be shocked if the insurer that responds tries to explain that the policyholder’s backaches are the result of a vehicle accident that occurred 12 years ago.

Regrettably, a significant number of people already have one or more health issues. You almost certainly have one, at least to some extent or another. Having a previous ailment does not automatically disqualify you for coverage, despite the fact that insurance companies love to invoke these clauses. You should work with an attorney who will know how to use your medical records to show the extent of your injuries that were caused by a workplace accident. This can ensure that a pre-existing condition is not exaggerated and used as a reason to deny a claim for workers’ compensation.

If you do not work with an attorney, you run the risk of having your claim denied. In addition, your attorney will need to be able to establish that an aggravated pre-existing condition is a legitimate ailment that should be taken into consideration for your workers’ compensation case. This may also impact how much do you get for workers’ comp.