Common Causes of Workers’ Compensation Denials

Despite meritorious claims, workers are denied benefits through workers’ compensation every day. Employers and their insurance carriers have a vested interest in denying as many claims as possible to avoid having to pay large payouts. Some reasons employers may deny workers’ compensation claims include:

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infographic_Common-Causes-of-Workers’-Compensation-Denials Common Causes of Workers' Compensation Denials

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Injury Was Not Reported Soon Enough

One of the most common reasons a workers’ compensation claim is denied is because the employee fails to report the injury immediately. Employers assume that if the injury was not reported immediately then it did not actually occur. However, situations may arise when an immediate report may not be possible, such as a worker having to seek immediate medical treatment. To avoid this problem, it is usually best to immediately report any injury that may result in any missed time from work.

Injury Was Not Witnessed

Employers often worry about fraudulent claims. If an injury was not witnessed by an objective person like a coworker or a supervisor, the employer may be hesitant to believe the injured employee’s story. However, simply because an injury was not witnessed does not mean that it did not occur in exactly the manner the employee described.

Injury Occurred Offsite

Workers’ compensation benefits are available for workers who sustain an injury while in the course of fulfilling their work duties. This extends to times when they are traveling on behalf of the business or driving to complete a work errand. In fact, one of the most common types of injuries involved in workers’ compensation claims is an injury stemming from an automotive accident. The best car accident attorney can explain that an employer can still be responsible for providing workers’ compensation benefits in cases where the injury occurred off the job site.

There Was a Pre-existing Injury

Just like in motor vehicle accidents, the best car accident attorney can explain that a common reason for denial is that the claimant had a preexisting injury. For example, if a worker had been injured in a car accident and then further injured his back when picking up a heavy box at work, the insurance company may try to deny the claim, stating that the worker had sustained the injury due to the car accident. However, if a worker does have a pre-existing injury and this condition is worsened by an accident at work, this does not disqualify the worker from workers’ compensation benefits.

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