Workers’ compensation claim denials are likely much more common than you might think. After all, the insurance company didn’t become a hugely profitable company by handing out awards every time a claim is filed. Sometimes the reasons for denial are legitimate, while other times you need to go the extra mile to prove your case. Below, we take a closer look at four common reasons for a workers’ compensation award denial, and what you should do in the event your claim is denied.
Work Comp Denials
Here’s a look at four common reasons why the insurance company may decline your workers’ compensation claim.
1. You Have A Pre-Existing Condition – If your medical records show that you’ve been battling shoulder pain for years, and you eventually decide to file a work injury claim, the insurance company may deny the claim on the basis that it was a pre-existing injury. However, if an accident at work resulted in further damage to an already damaged body part, you absolutely have a valid claim, and you should file an appeal of the ruling.
2. Weren’t Injured At Work – Even though an injury outside of work may cause you to miss work, it doesn’t mean that you are eligible for workers’ compensation. In order to receive compensation, the injury must occur during the commission of your work duties. Insurance companies know what signs to look for to suggest that someone’s injury actually occurred outside of work, and if the circumstances suggest it, they may deny your claim on suspicion that it happened elsewhere. If you have a legitimate claim, fight it.
3. Injury Occurred While Under The Influence – This one isn’t all that common, but if your employer believes that you may have been under the influence at the time of the accident, they can ask you to submit to a drug test. If the results of those tests show that you were impaired, the insurance company will deny your claim, although you may still have a legitimate claim to compensation if you can prove that the intoxication did not play a role in your injury.
4. Missed Deadlines/Incomplete Filing – There are strict deadlines when it comes to reporting a work injury, and if you miss these deadlines or send in incomplete paperwork, the insurance company will be happy to deny your claim. Make sure all paperwork is completed and filed well before necessary deadlines.
The easiest way to avoid having your workers’ compensation claim denied is to work with a workers’ compensation firm like Hey Workers. We will complete all paperwork in a timely manner, make a strong case that you were injured at work or that your work duties exacerbated your pre-existing injury, and we’ll do everything in our power to win you an award if you were under the influence. All of the above factors can be mitigated by hiring an injury firm to fight your case, so don’t leave it up to chance. Contact Hey Workers today.
