If you suffer an injury at work, you are entitled to compensation, but that doesn’t mean the process always runs smoothly. In fact, in numerous cases, your employer or their insurance company denies your claim for one reason or another. Because the other side often puts up a fight, it is imperative that you have a lawyer in your corner who can put together the strongest case to get you the compensation you rightfully deserve. But why are employers or insurance companies denying your injury claim? We share five situations where they might deny your claim so you can avoid these pitfalls.
Why Your Claim Was Denied
Here’s a look at five situations where your employer or their insurance company may argue that you are not entitled to work injury benefits:
1. You’re Not A Covered Employee – Depending on your employee status and how you were hired for the job, you may actually be an independent contractor or a freelance worker. This may make you ineligible for benefits, but don’t just assume your employer is correct about your status. Even if they tell you that you’re an independent contractor, check with your lawyer, because you may actually be a covered employee.
2. Didn’t Inform Employer In A Timely Manner – Today’s work culture is competitive, and many employees will try to work through pain or discomfort instead of taking time off to recover from an injury. While this may be admirable, it’s also unwise. If you fail to report your injury and it becomes a bigger issue down the road, your employer or their insurance company may deny your claim on the basis that you failed to report the injury when it first occurred.
3. Intentional or Negligent Injuries – A person is not allowed to collect an award for injuries that were intentionally inflicted upon themselves, so if the employer finds out that you tried to hurt yourself, your claim will be denied. This is different from self-inflicted injuries, like if you unintentionally struck your thumb with a hammer. Also, certain injuries arising from negligent actions, like wrestling with a co-worker on your lunch break, would likely lead to a claim denial.
4. Failed To Get Timely Medical Exam – If you claim to be in serious pain from a work accident, but you didn’t see a doctor for two weeks, it’s going to raise some red flags with your employer. The insurance company will likely argue that your injuries are not as serious as you claim them to be and deny your claim. You may have a legitimate reason for not getting timely medical care, but you’re going to have to prove it before a judge, because waiting a while can trigger a denial.
5. Not Work Related – Finally, if you were injured on the weekend or off the clock, you’re not going to be eligible for workers’ compensation, even if the injuries prevent you from being able to work. You may still have a claim if your work duties left you at a higher risk for an injury suffered off the clock, but it will again be an uphill battle that is best fought with an attorney.
For more information on claim denials or how to win compensation following a denial of benefits, reach out to Hey Workers today.
