Many people who are hurt on the job rely on workers’ compensation benefits. These benefits help to pay the bills while the injured employee is out of work. However, both the employer and the insurance company can try to step in to deny claims if they feel they shouldn’t or don’t need to. Here are just a few of the reasons why a workers’ compensation claim can be denied.
You Submitted Your Claim Too Late
There are time limits on filing a workers’ compensation claim so it is important to get your claim filed as soon as possible. The employer needs time to investigate the report and also look at any medical records you have if you’ve already seen a doctor. Plus, if you didn’t report the incident right away, many employers will assume that it didn’t happen or you would’ve said something sooner. So, make sure you say something as soon as possible.
You Didn’t Go to an Approved Provider or Facility
The employer and insurance company have a right to tell you which doctors or medical facilities you must go to, not only be diagnosed with a work injury but also to receive treatment. There are negative aspects to this, but you can always request a second opinion through a provider that is covered under your regular medical insurance instead of workers’ compensation.
You Have a Pre-Existing Condition
Many employers and workers’ compensation insurance companies will try very hard to deny claims on injuries that happen to be due to pre-existing conditions. There are many definitions of pre-existing conditions, but the hard fact is that if you had already hurt yourself previously and the regular duties of the job did not make it worse, but the injury at work did, they can deny you. And they will try.
There Is a Discrepancy
If there is a discrepancy between the account of events that you’ve given to your employer and the insurance agency, plus your doctor, and what the doctor finds upon various exams, your claim can be denied. It is important to always tell exactly what happened. Don’t exaggerate anything to make it sound worse than it is. And don’t leave anything out because someone might get in trouble.
The best thing to do if you are hurt on the job and your workers’ compensation claim has been denied, is to contact a workers’ compensation lawyer. A lawyer can help you navigate the rough waters of dealing with doctors, the insurance company, and your employer. Make sure you have legal help when getting the help you need from workers’ compensation.
Author Info: Hannah Whittenly is a freelance writer and mother of two from Sacramento, CA. She enjoys kayaking and reading books by the lake. You can find her on Twitter.
