After being injured in a workplace accident, you need compensation. After all, medical bills will quickly come due, and your inability to work will be stymied, thereby preventing you from earning the wages necessary to meet your basic needs. While that can be stressful in the moment, you should take comfort knowing that the workers’ compensation system can give you the relief that you need. A successful workers’ compensation claim can provide steady income to pay for your living expenses and medical care until you can get back to work.
That said, workers’ compensation claims are oftentimes denied. And when that happens, injured workers are often taken by surprise. They expect to be treated fairly during the workers’ compensation claims process, and a denial can feel like a slap in the face. Fortunately, though, you can anticipate some of these potential denials and diligently work to avoid them.
It may not seem like it at first glance, but there are a number of reasons why workers’ compensation claims are denied. Here are some of them:
- The existence of a pre-existing condition: If your employer’s insurance company can show that you have a pre-existing condition that’s responsible for your pain and mobility limitations, then they might be able to sidestep granting your workers’ compensation claim. You won’t be precluded from seeking workers’ compensation benefits just because you have a pre-existing condition, but you’ll have to show that your condition was exacerbated by your work duties if you want to successfully claim benefits.
- You delayed in reporting your injuries: There are strict timelines in place when it comes to reporting your workplace accident and your resulting injuries. If you wait too long to report them to your employer, then your workers’ compensation claim is bound to be denied. After all, it’ll be easier for your employer and their insurer to argue that your injuries aren’t all that severe if it took you a long time to report them.
- Your own actions caused your injuries: While you don’t have to show negligence on your employer’s part to recover workers’ compensation benefits, your claim can be denied if it’s shown that you intentionally injured yourself, you were engaged in horseplay when your injuries were suffered, or if you were under the influence of drugs or alcohol at the time of the workplace accident. So, be cognizant of how your actions appear going into your claim review.
- There’s no corroborating evidence: You probably hope that the insurance company will take you at your word, but the reality is that they’re going to be skeptical of your claim. That’s why it’s imperative that you have other evidence to corroborate your workplace accident and your injuries. Witnesses, security footage, and medical records can all play a pivotal role here.
Be proactive to avoid workers’ compensation claim denial
There’s simply too much on the line for you to overlook an aspect of your workers’ compensation case, thereby putting your benefits in jeopardy. So, as you proceed through the claims process, be cognizant of common claim denial justifications, then diligently work to gather evidence and act in ways that head those justifications off.
By doing so, you’ll hopefully secure an outcome that stabilizes your finances and allows you to obtain the medical care that you need. With this support, you’ll hopefully then be able to get back on your feet and reclaim your normal life without having to devastate your finances.