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Reasons Why Your Workers’ Compensation Claim Was Denied (And How An Attorney Can Help)

by Mar 9, 20230 comments

Reasons Why Your Workers’ Compensation Claim Was Denied (And How An Attorney Can Help)

Dealing with a denied workers’ compensation claim is frustrating and warrants a call to an experienced lawyer. The workers’ compensation process is complicated, and trying to navigate it alone can result in denied coverage. Let’s explore the common reasons why your workers’ compensation claim was denied: 

  1. The Injury Didn’t Occur At Work 

To qualify for workers’ compensation, the injury needs to have occurred at the workplace while you were on the clock. For example, if you fall while completing a project, you’re likely to qualify for workers’ compensation. If an injury happens during a lunch break, however, you may not qualify. A small gray exists where workers are injured while completing an assignment while on the clock but not on the job site (for example, a delivery driver getting into a crash). Likewise, job retreats or conferences can be another gray area, warrantying help from an attorney. 

  1. You Missed Important Deadlines

Deadlines exist for filing your workers’ compensation claim. You also need to inform your employer of your injury and your intent to file a claim in a timely manner as well. Not reporting your injury gives your workplace the opportunity to conduct its own investigation, which can easily be biased. Often, these requirements are missed simply because an employee is unaware of the entire process. A lawyer ensures you fulfill every step meticulously and completely.

  1. Medical Reasons for Doubt

Employers and their insurance companies may try to argue that an employee had an existing medical condition leading to the injury. This argument may either dismiss a claim outright or limit the amount of compensation an employee may receive. Injured employees are also required to receive medical treatment from the company’s approved list of doctors—though not every company will have such a list. Unfortunately, these doctors can sometimes downplay an employee’s injuries. Regardless of whether or not there’s a list of approved doctors, an injured employee must still receive medical treatment and supply evidence of this when submitting a claim. 

  1. Your Injury Resulted From Some Form of Company Violation 

Actions like not exercising proper safety procedures, not wearing the right equipment, or engaging and “horseplay” or practical jokes can cause your claim to be denied. You can also have a claim denied if there’s reason to believe that you were intoxicated or using drugs when the injury happened. Getting into a fight with a coworker also results in denied coverage. All of these are legitimate reasons for having a claim denied, but it’s possible for a workplace to create false allegations against an employee. An attorney can help fight false allegations. 

  1. Your Injury Is Hard to Link to the Workplace

A broken arm due to a product falling from above is fairly straightforward to prove. Developing lung cancer from deadly fumes, however, is much harder to prove. A Newark workers compensation lawyer can help injured employees receive the compensation they need when their claim is denied, and our friends at Rispoli & Borneo P.C. agree that having a lawyer is paramount. 

Palm Beach car accident lawyer

We have offices in Florida, Georgia and Illinois. It is not only important to talk to an experienced workers’ compensation lawyer when you have been hurt on the job, it is also the best way to make sure that you receive proper medical services and lost wages you are entitled to under the law. After all, the Workers’ Compensation law was created to protect you – the employee.

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Devin Major
Devin Major
August 9, 2022.
Best team I had ever working for me I really hope anybody who needs legal advise call them
Gregory Diggs
Gregory Diggs
August 4, 2022.
I recommend this law firm to anyone with a worker's compensation case. The staff does a great job and they treat you like family. Judd Koenig was my attorney and went the extra mile and then some more securing my a nice settlement of my case.
Cynthia Murray
Cynthia Murray
August 3, 2022.
Great Attorney thank you Eric Lakind and staff Attentive, friendly, answered ever questions got results when I could not do it myself Cynthia
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Naisha Dorvilus
August 2, 2022.
Lisa was my lawyer she asked me questions and was very helpful. She and her team communicated with me about my cause and I'm super happy with her service.i will definitely recommend her and her company
Jaime Ieli
Jaime Ieli
July 29, 2022.
My husband was hurt and never dealt with an attorney before. He looked up attorneys online & thru the grace of God got Lissa Dorsey as his attorney & she was truly amazing! She was very involved, always returned our phone calls & made the whole process as easy for us as she possibly could while my husband treated with Dr's and started his healing process. I would recommend her to any & everyone without a doubt.
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July 21, 2022.
Best law firm in Palm Beach County, Lisa and Kim were the best. I recommend this law firm to everyone.
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July 20, 2022.
Wasn't sure how it would work with me being in one town and lawyer in another but it all worked out in the end thank you for all your hard work.
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July 19, 2022.
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July 12, 2022.
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