Thousands of workers are injured on the job every single day, and if these injuries lead to medical expenses and time away from work, those employees may be eligible for workers’ compensation. Even if you are eligible for compensation, it’s not uncommon to learn that your claim was denied by the insurance company for one reason or another. Certain types of injuries are notorious for receiving initial denials, and in today’s blog, we’re going to explain why claims for certain types of injuries are oftentimes denied by the insurance company.
Work Injuries That Are Commonly Denied
An initial denial should not be the end of your quest for compensation, because a significant portion of claims are denied following the first petition for benefits. Here’s a look at four types of claims that are oftentimes denied by insurance, and an explanation as to why these cases may receive an initial denial.
1. Repetitive Strain – Repetitive stress injuries are incredibly common among certain types of workers who perform the same tasks day in and day out, but because there isn’t typically an acute moment of injury, the insurance company may assume that factors outside of work contributed to your condition. The insurance company may also argue that your symptoms are simply a byproduct of aging. We can help showcase that your repetitive strain injuries are a direct result of your work duties.
2. Pre-Existing Conditions – Let’s say that you previously had surgery to repair a torn rotator cuff in your shoulder, and then you later developed pain in the shoulder while performing work duties. The insurance company may deny your claim, saying that your symptoms are actually related to the original injury and surgery, not your work duties. Even if you have a preexisting condition, you are still eligible for compensation if your work duties exacerbate the issue. You’ll just need to be a little more thorough in proving that it was your work duties that led to the new symptoms.
3. Psychological Injuries – The insurance company likes to be able to point to tangible injuries when paying out a claim. If you break your arm at work, the insurance company will easily be able to verify this claim by reviewing the X-rays that your doctor takes. The same type of verification cannot be said about psychological or mental injuries. If you are dealing with Post-Traumatic Stress Disorder or another mental health condition like depression that your doctor believes is a direct result of your line of work, you may be eligible for compensation, but there’s a good chance that the insurance company will deny your initial claim and ask for more proof of the connection between your work duties and your mental health condition. Again, a lawyer can help make this connection very clear to the insurance provider.
4. Violence-Related Injuries – Finally, if you are injured as a result of workplace violence, your workers’ compensation provider may attempt to say that you actually need to seek compensation from the aggressor and their insurance company, not your employer’s insurance provider. If you’re a nurse who was assaulted on the job or you are a police officer who was injured in the line of duty, while you may be able to pursue compensation in different forms, that doesn’t mean you are ineligible for workers’ compensation. Even though you may not have been injured in a standard manner on the job, you can still collect workers’ compensation if a violent act by another party leads to your injuries.
We can help you prevent an initial denial or overcome a denial if your first quest for compensation fails to yield the right results. For more information, or for help with your injury claim, reach out to the team at Hey Workers today at (844) 439-9675.