Saturday, April 1

5 Reasons Why Your Workers’ Compensation Claim can be denied

As a worker of any legal organization, you are entitled to compensation in case of an accident. This compensation is clearly outlined in the workers’ compensation policy that lays bare the procedure of filing a claim in case of an injury on duty.

It is important to note that the workers’ compensation system can be complicated, and your claim could be denied for several reasons. Well, there is room for the appeal to a denied claim, but it is essential to establish the possible reasons why your claim could be rejected.

Possible reasons that can disqualify you from workers’ comp

Failure to notify the employer on time

After the injury, you are expected to file a workers compensation claim within a certain period. For example, some employers will require you to submit the claim within thirty days. In case the period expires, you are no longer qualified for compensation. It would be best if you observed the time limits for filing the claim for various reasons.

Filing a claim on time allows your employer to carry out accident investigations and establish the truth in your claim to initiate the compensation process. You should also know that your employer and the agents from the insurance company could be working to prove that your injury claim did not happen at the workplace or while executing work-related assignments. Thus, time becomes of essence in supporting your application.

Your injury happened outside the workplace

You are only eligible for the workers’ compensation benefits if your injury occurred while performing your work-related roles. For example, if you are a mechanic and you injured your hand while fixing a car, you are likely owed compensation benefits. However, if you were injured while walking to the workplace, you may not be eligible for compensation. 

There exists a grey area in establishing whether you were injured while at the workplace or carrying out work-related duties elsewhere. In case the employer and the insurance company works hard to prove otherwise while making attempts to deny your claim, you can consult an experienced workers’ compensation attorney.

He or she will represent you before the administrative judge to ensure that you get the compensation you deserve from the damages and injuries incurred. Hiring a lawyer increases your chances of getting compensated. An experienced lawyer will guide you through the process of filing the claim and advise you accordingly; thus you have a better chance of compensation. Working with a lawyer also allows you the opportunity and time to recover without having to worry about the claim process.

The injury happened while you were intoxicated

Virtually no workplace will allow workers to work while intoxicated or under the influence of drugs. For example, if it is established that you were injured because you were operating a machine under the influence of drugs, you may become ineligible for the compensation. An employer might request tests for drugs in your blood to establish if you have been using drugs. In case you test positive, then your claim is often automatically denied. 

You were not treated by an approved medical provider

In many cases, the employer and the insurance company will provide you with a list of doctors you may visit and consult in case of an injury. You might decide to visit any doctor, but you might run into trouble with your claim if your doctor has legal issues or license problems. So, ensure you only get treatment from a proper medical practitioner and keep your medical records intact. 

Your employer may dispute your claim

Again, after filing your compensation claim, your employer can find reasons to dispute. For example, the employer might cite inadequate evidence, incorrect details, or even your failure to file the claim timely.

For whatever reason that may be, most employers are afraid of the costs of covering the injured workers and the benefits they are expected to remit. That is why you must gather all possible supporting documents you have to support your claim, and in case you have witnesses, it is good to tag them along so they can testify. You should also seek legal help from a personal injury lawyer who can help you fight for your rights. 

Final word

As a worker, you are protected at your workplace and entitled to compensation benefits in the event of an accident. That said, keep an eye on rules and safety guidelines at work, plus you ought to follow the stipulated due process to file for compensation. Also, speak to an attorney with a good track record to assist in the process.

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