Is Your Workers Compensation Claim Denied? Find Out Why

There is an eligibility requirement for workers compensation coverage. Your employer should have a workers compensation insurance policy that covers you in case of injuries while at work. Nearly all states require employers to have this insurance cover.

Sometimes, you could file for compensation only for the insurer to deny your claim. If simple errors are the reasons for denial, your employer can sometimes fix the problem. However, if the reasons were unfounded, engage a credible workers compensation lawyer to appeal your case.

Below are possible reasons why your workers compensation claim could be rejected.

You Failed to Notify Your Employer on Time 

Once you get injured at your workplace, you should quickly report the incident to your employer. That way, you have an edge when building a strong case to ensure you get your benefits.

Every state has its own rules on when you should report your injury. For instance, in Oregon, you have to notify your employer right away and fill out a claim form. Your employer has only five days to report to their insurer. The insurance company then has to respond to your claim within 60 days from when your employer became aware of your injury.

You need to find out the notice deadlines set by your state, so you don't miss out on your settlement. If you're uncertain about the applicable laws, contact an experienced workers compensation lawyer and find out how to file an official claim.

Your Injury Comes from a Preexisting Condition

If you suffer an injury from a preexisting condition, the insurance company may hesitate to compensate you. But if you can prove that your injury from work aggravated your preexisting illness, there's a high chance your case will be successful. For instance, if your condition gets worse because you had to work with risky substances, you'll likely receive compensation benefits.

Another example is when you previously had a car accident that caused you chronic back pain. If your back got worse from lifting heavy boxes at work, you can file a workers compensation claim if the pain gets worse. Make sure to only work with an experienced workers compensation attorney to increase your chances of fair compensation.

Your Employer Can Prove That Your Injury Happened Outside Work 

The insurance company may deny your claim if they think you got injured outside your workplace. For instance, if your back injury occurred while playing for the company softball team, you may be ineligible for workers compensation.  

Also, if you have an accident while you take your dog out for a walk, the insurer will deny your claim because your injury occurred during your personal time, not at work.

Many insurance companies are becoming increasingly strict about what they consider to be work-related injuries. That's why you have to prove that you were hurt on the job to qualify for worker compensation. But if you have trouble making a strong case, a qualified attorney can help. 

For more information, contact a workers compensation lawyer near you.


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