Wokers' Compensation Claims: Understanding Why Your Case Was Denied

Filing a workers' comp claim for benefits after you have been injured on the job sounds easy enough. Unfortunately, it isn't, and workers' compensation claims are often denied for various reasons—and this can be extremely stressful for all involved.

So what can you do if your claim is denied?

Understand the Reasons Your Case Was Denied

As mentioned above, there are several reasons your case may be denied. Some of the most common reasons include:

  • There Were No Eyewitnesses: A workers' comp claim without any witnesses will usually be denied—very quickly. Although it is impossible to find a witness when there wasn't one, it doesn't mean you are out of luck. Proper documents and reference reports can help resolve your issue.
  • The Injury was Reported Much Later: Workers' comp insurers will usually deny a case when the medical report was filed later than the initial injury. As you might expect, this is because injuries can worsen over time—especially serious ones. Even if you experience a very mild injury, do your best to see a doctor immediately—or within the next few hours. You should also visit your boss and file an accident claim at work.
  • Differences in Your Statement and Medical Records: In order for your claim to be approved, you need to match your official statement and report with your medical records. The injuries you suffer should always match your injuries, no matter how small it may seem. When you visit your doctor, be sure you tell him or her exactly how you were injured and have them make a note of it in your file.
  • You No Longer Work at the Company: Sometimes, employees wait to file their workers' comp claims. Unfortunately, during this wait period it is possible to be laid-off—or even worse, fired. This is why it is so important that you file your case immediately following the incident.
  • You Did Not Give The Insurance Company a Statement: In most workers' comp claims, the injured party is required to give an official statement about their injury and accident to the insurer. If you refuse to make this statement, it is possible you will be denied. If you do not want to give a statement, consider calling a lawyer for legal representation.

Other reasons for a denial may include the presence of drugs or alcohol in your system and the refusal to authorize medical waivers.

Although the workers' compensation system is complicated, it is possible to get the benefits you deserve for being injured on the job. If your case was denied, contact a personal injury (or worker's compensation) lawyer like Ransom, Gilbertson, Martin & Ratliff, L.L.P immediately and file an appeal.