Whether you work a job that comes with its fair share of health risks or you have a desk job, anyone can get injured anywhere. But, when you do get injured, things can easily get out of hand with the medical bills piling up and dealing with the pain of the injuries.
Fortunately, workers’ compensation benefits can cover your medical expenses and lost wages while you recover from an accident at work. But, just because they exist to help you, doesn’t mean they will always pay out. Many compensation claims get denied.
Whether you have had a denied claim or you want to avoid that issue altogether, you need to understand the common reasons why these claims can get denied.
To give you an idea, here are some common reasons why workers’ compensation claims are denied, and what you can do to avoid or overcome these obstacles.
Lack of Notification or Late Reporting
One of the main reasons why workers’ compensation claims get denied is late reporting or failing to notify your employer about the injury as soon as it happens.
Most states have strict deadlines for reporting workplace injuries, which is often within days of the incident.
If you delay reporting your injury to your employer, the insurance company might argue that your injury wasn’t severe or that it didn’t happen at work. Some people avoid telling because they don’t want to sit at home recovering from an injury instead of making money. What they don’t understand is that the worker’s comp can pay them for the lost wages.
But, you need to report the injury immediately and make sure it’s documented properly.
Insufficient Medical Evidence
Another common reason for denial is insufficient or improper medical evidence.
To have a claim, you need to support it with detailed medical records that clearly link your injury to your work activities. Sometimes, initial medical reports may not adequately detail the extent of your injury or its connection to your job duties. That is why you need to seek medical attention immediately after an injury, follow your doctor’s advice, and make sure all medical records accurately describe how your work caused or aggravated your condition.
If you are not sure how to do it by yourself, you can always work with a workers compensation attorney to make sure your claim is properly filed.
Pre-existing Conditions
If you have a pre-existing condition that is similar to the injury you are claiming for, the insurance company might deny your claim, arguing that your current injury is not work-related but rather a result of a pre-existing condition.
However, workers’ compensation covers aggravation of pre-existing conditions if your work exacerbated them. That is why you need to disclose any pre-existing conditions upfront and provide evidence showing how your work duties worsen your condition.
You should consult with a workers compensation lawyer to figure out how you can do this the right way.
Missed Filing Deadlines
When it comes to legal issues, there are many things you need to keep track of, like deadlines.
Other than the reporting deadlines, workers’ compensation claims have filing deadlines that vary by state. Missing these deadlines can result in automatic denial of your claim. Make sure you understand the deadlines specific to your state and file all necessary paperwork on time.
If you are not sure about the deadlines or procedures, consider consulting with a workers’ compensation attorney who can guide you through the process.