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Why has your claim been denied?

On Behalf of | Jan 10, 2022 | Workers' Compensation

Workers’ compensation is a vital part of protecting employees on the job. It allows for injured workers to get help covering their expenses for medicine, rehabilitation and surgery. It even provides compensation for impaired workers, offers to retrain, or provides for the surviving family members if the incident resulted in an employee’s death.

But unfortunately, workers’ compensation claims do not always get approved. But what are the reasons a claim might end up denied?

Can you appeal?

It is important to understand workers’ compensation, first and foremost. The good news right off the bat? Even if you face a denial, it is not the final word. Plenty of perfectly valid workers’ compensation claims end up denied the first time around. You can appeal the initial ruling, however, and continue to press forward and seek your compensation.

Reasons for a denial

It is still important to know the main reasons that claims end up denied, though. A few of the most common reasons include:

  • If the injury actually happened due to the worker
  • If the injured worker did not immediately notify employers
  • If they took longer than a year to file the claim, thus passing the statute of limitations
  • If they did not seek a doctor’s visit
  • If the claim overstated the injury
  • If there was no causal link between the injury and the worker’s job
  • If the injury held an undetermined cause that did not tie to the worker’s job

Of course, figuring out whether or not your case qualifies can feel like an unwanted slog especially during recovery. This is why you may want to seek legal help to give you the support and guidance you need along the way.