Common Reasons For Workers’ Compensation Claim Denials

If your workers’ compensation claim has been denied, do not despair yet. There may be a chance that an issue is easily repairable, and that you can still receive fair benefits to cover costs for wage loss and medical treatment. The appealing process can be complex, so it’s important to have a seasoned lawyer walk you through each step of the way. Some of the most common reasons that a workers’ compensation claim gets denied include:

  • Filing the claim after you were let go
  • Refusing to provide a recorded statement
  • Conflict between the medical records and accident report
  • Unwitnessed injury
  • Suspected fraud
  • Inaccurate or incomplete paperwork
  • Illness or injury was from a pre-existing condition
  • Failing to pursue proper medical care
  • Failing or refusing the alcohol and/or drug test
  • Evidence of recklessness or negligence
  • Failing to file claim by deadlines

If you filed a claim after being terminated, the insurance company may view your claim as not relevant because you didn’t report it while still employed, and thus, it must not be serious. But it’s possible you were terminated after notifying your employer of the accident, and this was in an attempt to save the company money by avoiding paying you in benefits.

Or, perhaps you just hadn’t realized the extent of your injuries initially, but now have medical bills to pay for. In any case, it helps to seek advice from a lawyer so you know your options moving forward. And if your lawyer thinks your situation warrants a workers’ compensation claim appeal, they can get you started on making that happen. 
Consider speaking with a dedicated lawyer about your workplace injury, such as a Workers Compensation Attorney from Rispoli & Borneo, P.C.