Reasons For Workers' Comp Claim Denials

Posted on: 4 December 2018

If you have been injured at work, you may be concerned about whether or nor your workers' compensation claim will be approved. Even though an injury occurred in a place of business, it may not be automatically approved. Workers' compensation claims may be denied due to simple mistakes. 

Here are a few avoidable reasons why a workers' compensation claim may receive a denial.

Slow Reporting

Sometimes, a worker may fail to report an injury immediately after it occurs. Although the employee may be trying to wait to determine the severity of the injury, the delay does not work in their favor. 

The longer the delay in reporting the injury, the greater the likelihood of a claim denial. An automatic denial may be rendered if the delay exceeds a month or so.

Failure to Seek Prompt Medical Treatment

Once a person has been hurt in the workplace, they should report the issue to their supervisor and request to see a doctor. If the request is denied, the worker should visit an emergency room or walk-in clinic. 

As the time between the accident and the receipt of medical treatment grows, the workers' compensation claim is more apt to be denied. The person's employer and the workers' compensation insurer may suggest that if an injury did occur, it was not serious enough to warrant medical care.

Lack of Evidence of an Accident

Evidence should be available to indicate that a workplace accident occurred. To show that the accident occurred as the victim was working, witness statements should be obtained. It is important to document what transpired before memories become foggy.

Failure to Disclose Prior Injuries

If a worker has been injured by a prior event, they should be sure to disclose this information when asked. Some employers inquire about prior injuries during the hiring process. Regardless of when an employer asks, failing to disclose the prior injuries could result in a workers' compensation claim denial, especially if the injury is similar to the one the employee received in the workplace.

Failure to Pass a Drug Test

An employer may perform a drug test after the accident. If the workers' test results indicate the presence of drugs or alcohol in their system, their claim may be denied. Still, if the drugs are prescribed medications, a workers' compensation lawyer may be able to help overturn the denial.

If you have been injured in the workplace, schedule a consultation with a workers' compensation attorney at a law firm like Kavanagh & Kavanagh Law Ofc in your local area.


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