Reasons Workers’ Compensation Claims Can Be Denied

Many employees are frustrated with having to deal with work-related accidents and injuries without appropriate compensation. Often, employees have their workers’ compensation claim denied after incidents. This usually leads to a lawsuit instituted to enforce their right and compel employers to pay their claims. However, many employees are often unsure about the reason for denied worker’s compensation claims.

This article discusses some of the most common reasons a workers’ compensation insurer can deny the legitimacy of your workers’ compensation claim.

No Witness for Your Injury

Workers’ compensation insurers don’t like to hear that your injury was unwitnessed. They question the integrity of unwitnessed accidents. Sadly, if you get hurt at work, and no one saw it, there is nothing that you can do about that. It is important to report work-related injuries immediately.

You Did Not Report Your Injury Immediately

Most states’ workers’ compensation laws require you to report work-related injuries within a short period, say within seven days. Insurers generally don’t approve that you didn’t report your accident immediately. They often assume that you weren’t actually hurt. If you are injured at work, and you believe that your injury has the chance of causing you to miss work or need medical care, report it immediately to a supervisor and fill out an accident report.

Inconsistency in Your Accident Reporting

Insurers will often deny workers’ compensation claims if the employee’ gives inconsistent statements about how the accident occurred. If you inform your supervisor that your accident happened one way but tell your doctor a different thing, then this can be a problem. Make sure you are consistent about what you tell co-workers, supervisors, and health care providers.

Presence of Illegal Drugs in Your System

If work-related accident testing proves that you were under the influence of illegal drugs when the incident occurred, the insurers would usually deny your claims.

Your Claim was Filed After You Were Fired from a Job

Insurers don’t approve of workers’ compensation claims filed after the employee was fired or laid off. They assume that the claim is a revenge claim. If you are laid off before you file your claim, you will find it difficult to convince the insurer and the workers’ compensation judge that you were legitimately injured at work.

You Refused to Sign Medical Authorizations or Give the Insurance Company a Recorded Statement

Generally, insurers ask the employee to sign medical authorizations to directly write to the employee’s health care providers to obtain the employee’s medical records and bills. The employee has no legal obligation to sign medical authorizations. The employees are obligated to receive their medical records and bills relating to the work accident and give them to the insurer. However, insurers don’t trust injured employees and prefer to get medical records on their own. This enables the insurer to get a complete file and sometimes get medical records that do not relate to the work accident. If the insurer pushes you to sign a medical authorization against your will, contact a worker’s compensation attorney immediately.

Sometimes insurers request injured employees to give a recorded statement describing the accident and the injuries. Although you’re not legally required to provide this recording if you choose to provide one it can be useful to consult with a lawyer before the interview. An insurer asking for a statement can indicate that they have a problem with the case. If you refuse to give the statement, it provides the adjuster with reason to say that the insurer denied your compensation benefits because of your refusal.

Avoid these missteps. Workers’ compensation coverage can be hard to understand. The experts at Pittman Insurance Group, LLC are available to discuss and clarify any questions you might have about workers’ compensation insurance. Contact us right now to get answers from our experienced representatives.

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