The workers’ compensation system is designed to help protect injured workers by providing financial assistance if a work injury forces them to miss time from work or leads to medical expenses. It seems like it should be pretty simple to file a claim and collect compensation if you have a valid injury, but you’d be amazed at how many injury claims get denied for one reason or another. In today’s blog, we take a look at some of the reasons why so many workers’ compensation claims get denied so that you can avoid these pitfalls.
Why Work Comp Claims Get Rejected
Work comp claims can be rejected by your company’s insurance provider for a number of different reasons. Sometimes there are legitimate problems with your claim that require a denial, while other times the insurance company may err on the side of caution and decide they want to deny your claim until they receive some more information. Here’s a look at some of the reasons why so many work comp claims get denied.
Missed Deadlines – You have strict deadlines for filing a workers’ compensation claim. If you drag your feet too long, you may miss your window of opportunity, or the insurance company may have doubts about the true nature of your injury.
Failed To Report Your Injury – You need to report your injury to your company so that they can start processing paperwork on their end. If you don’t report your injury to your employer until a couple days after the injury, that will give the insurance company some doubts about how your injury occurred.
Missing Paperwork or Information – If you didn’t fill out all the forms correctly, you’re missing documents or parts of your paperwork are incomplete, the insurance company can deny your claim, even though your injury was legitimate.
Differing Doctor Opinion – You can see a doctor of your choosing after an injury to verify the existence and extent of your injuries, but the insurance company can also request that you get an independent medical exam from a provider of their choosing. If the two professionals disagree, your claim may be denied if you try to pursue benefits based on the recommendations of your physician.
Pre-existing Injury – The insurance company may argue that your injuries are actually the result of a previous injury that you suffered earlier in life when you were off the clock. If you suffered a knee injury in college and then knee pain developed at work, the insurance company may point to the pre-existing injury as a reason for denial.
Fraud – If something just doesn’t add up with your claim, or you can’t produce enough evidence to support your story, the insurance company may deny your claims over the belief that you are attempting to commit fraud.
If your claim is denied, it’s not the end of the line. Interestingly, the best way to avoid a denial and to counter a claim denial are the same, and that’s to sync up with a workers’ compensation law firm like Hey Workers. We can ensure your claim is filed correctly, on time and with sufficient evidence to earn an approval. If your claim is denied, we can work to correct the errors or put together an airtight case to ensure it’s approved when you appeal. For more information on how we can help do this, reach out to our team today at (844) 439-9675.
