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Why would a workers’ comp claim be denied?

On Behalf of | Nov 29, 2022 | Workers' Compensation |

You were recently injured at work and, as a result, it’s caused you to lose out on work and build up a ton of medical debt – this happens quite frequently, so people file a workers’ compensation claim. Workers’ compensation is a benefits plan for employees who are injured or develop an illness during their job. These benefits, typically, help compensate workers for their lost wages and medical bills and benefit survivors of workers who suffered from fatal injuries.

Workers’ comp is a no-fault system, or, in other words, it doesn’t matter how or who caused the injury, the injured workers – as long as the injuries weren’t deliberately self-inflicted – will receive benefits. These benefits aren’t immediately awarded, to many people’s disappointment. Instead, employees have to report their injuries and file a claim.

During the claim process and evaluation, your claim could be denied, which can be confusing. There are often a few common reasons why a workers’ comp claim would be denied. Here’s what you should know:

It’s suspected your injury occurred outside of work

You should report an injury at work as soon as it happens, otherwise, a workers’ comp claim could be denied. If you report an injury a day later, your employer may suspect you suffered your injuries outside of work. Your claim could be denied if you reported your injuries late.

You didn’t report your injury in time

You should report an injury within the statute of limitations. Legally speaking, employees have 90 days of an injury to report to their employer. Following the injury, you have two years to begin filing a workers’ compensation petition. Failing to meet these dates could cause a denied claim.

You didn’t receive the correct medical evaluation

You’ll have to present your medical records when filing for workers’ comp. Not only should you seek medical attention for your injuries but you should seek a doctor who is approved to evaluate your injuries for workers’ comp. Reaching out to the wrong doctor or not reporting enough evidence of your injury may result in a denied claim.

Working with someone who knows the law may be able to help you receive full workers’ compensation benefits.


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