Some reasons for denying workers' compensation claims are outside of your control, but there are still things you can do to make sure yours is likely to be successful. For example, it's recommended that you get medical treatment right away after an injury. This is both because you could be injured worse than you thought (and to prevent the injury from worsening through neglect) and because a medical diagnosis lends authority to your claim.
Here are three reasons why your claim could be denied.
1. You don't have the records or didn't meet the deadlines
When you're injured at work, it can be difficult or even impossible (depending on how badly you're incapacitated) to be on top of things enough to make sure everything gets recorded and all the paperwork gets completed and turned in. So you may need to get some help from family or friends with this, but it's crucial to make sure you report your injury right away, get medical treatment right away, and keep track of the paperwork, as well as filing your claim within the necessary time frame.
2. Your employer disputes the claim
Some employers care more about their employers than others, and some can be a bit unscrupulous. The unscrupulous type of employer could actually look at your claim with a view toward finding a way to discredit it. For example, if you can't prove that the injury occurred during work hours, or if they can claim that you weren't doing work at the time you were injured but instead were participating in risky, non-work-related behavior, they may decide to dispute your claim.
3. It's the "wrong" kind of injury
Some injuries are usually covered by workers' compensation, while others aren't, and some are lodged in a gray area. For example, stress-related injuries may or may not be covered. States vary in their workers' compensation laws; North Carolina, for instance, tends to only cover traumatic back injuries and injuries caused by accidents. In other states, though, greater coverage is offered, and even mental health problems caused by work can be covered in some areas.
These three reasons show how workers' compensation claims can sometimes be denied even through no fault of your own. If you believe that your claim was denied wrongfully, you should first collect all the information and all the records you can about the incident, and then contact a reputable lawyer, such as Gerald Lutkenhaus, to consult with about whether or not you have a case.Share