5 Common Reasons For Workers' Compensation Claim Denial

31 July 2018
 Categories: Law, Blog


When filing a workers' compensation claim, there's always the potential for your claim — no matter how legitimate — to be denied by your employer's insurance provider. Knowing why your claim was denied can be a tremendous help as you go through the appeals process. If you haven't filed a workers' comp claim yet, avoiding the following can help improve your chances of a successful claim.

1. Failure to File Immediately After an Injury

There are plenty of good reasons why you should always report work-related injuries as soon as they happen. For starters, most workers' comp rules require injuries to be reported within a short amount of time. In some cases, you may only have a week to file an accident report concerning your injury.

Secondly, failing to report an injury immediately afterward can also hurt your chances with your employer's workers' comp insurer. Waiting days or weeks after an accident before filing actually downplays the severity of your injuries in the eyes of the insurers, making them more likely to deny your claim the longer you wait.

2. Filing a Claim After Being Fired or Laid Off

Being fired or laid off after a work-related injury can also hurt your chances of a successful workers' comp claim. Most insurance providers assume that a workers comp claim filed after a layoff or termination is merely a revenge claim, even if you have a perfectly valid case for receiving benefits.

If you were fired before you could file a workers comp claim or while you were attempting to file one, you could have a case for a retaliatory firing. Speaking to a seasoned attorney can help you discover your options for moving forward.

3. Inconsistent Records and Reports

Consistency is the key when it comes to filing a successful workers' comp claim, especially since many claims are denied due to reports and records that simply don't match up. If you tell your doctor how the accident happened in a way that's different from how you told your supervisors and co-workers, the resulting discrepancies can be enough to stop your workers' comp claim in its tracks.

4. Failure to Give a Statement or Medical Authorization

You don't have any legal obligation to provide a recorded statement concerning your injuries to your employer's insurance company, nor do you have any obligation to sign medical authorizations allowing your employer's healthcare provider to access your medical history. Nevertheless, a refusal to do either could result in a denied workers' comp claim. This is where hiring a trusted workers compensation attorney can make all the difference.

5. Unwitnessed Injuries

If your injury happens out of sight and out of earshot of nearby workers, you could have a harder time with your workers' comp claim. Unfortunately, not every accident comes with helpful witnesses who can provide accurate reports and testimony. Nevertheless, you should report your injuries to your coworkers and the closest available supervisor immediately after they occur.

Contact a lawyer like those at Gilbert, Blaszcyk & Milburn LLP for more information.