Reasons Why Your Workers Compensation May Be Denied

Getting hurt on the job is something that no one wants to ever experience. Not only do you have to go through a pile of paperwork to document exactly how and why you were injured, but you then have to worry about how you will be compensated while you are out of work trying to get better. Applying for workers compensation is the first step you should take, because that insurance is in place to protect workers if they are injured on the job. However, if you end up finding you claim denied, then the stress and worry really sets in. This article will provide details on three of the biggest reasons why workers compensation may be denied.

Denial of Legitimate Claims

Workers compensation insurers do deny legitimate claims, and when this happens these employees need to hire a lawyer and start to work their way through the system to ensure they receive the compensation they deserve. There are many reasons why the insurer may deny your claim, including the following reasons: 

  • There were no witnesses to your injury
  • You failed to report your injury immediately
  • There was a discrepancy between the accident report you filed and your medical records 

Unwitnessed Injury 

Workers compensation insurers need documentation that your injury  happened, and one of the best ways to receive that documentation is from a witness to the accident, so they will question most unwitnessed accidents. If you get hurt at work and had no witnesses to your accident, that's not your fault, but in these circumstances you should immediately report your accident to your managers and co-workers. Make certain you tell everyone the same thing about what happened. Co-workers can testify on your behalf that you were in after your injury, and if everyone is told the same account of what happened, the insurer is most likely to believe your story. 

Injury was Not Immediately Reported 

If you don't report your accident immediately after it happened, the insurer is going to think you weren't really hurt. In fact, most states require that you report your injury within seven days. If you get hurt at work and feel that your injury may be severe enough to keep you from working for even a little while, immediately fill out an accident report. 

Medical Record Discrepancy 

Claims may be denied by insurers if there are inconsistent descriptions about what happened. You may tell your employer one account of what happened, but then provide an entirely different account to your doctor. No doubt this will hurt your case. Make sure the everyone you tell gets the same account, because your doctor is going to base part of their opinion on your injury on the way the injury happened.

If you find yourself denied for these or another reason, you can appeal that decision. The appeals process varies from state to state, but usually the first step is an administrative hearing before an administrative law judge through the workers compensation board of state labor department. Contact an experienced workers comp lawyer for legal assistance during the appeals process.