Top Reasons why a Workers Compensation Claim Might Be Denied

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When injured at work or develop an illness due to constant exposure to harmful chemicals or elements, the law makes it possible for you to get compensation from your employer through the workers’ compensation act. Even though the majority of the claims are often settled, a certain percentage of the claims filed often go down the drain. Unfortunately, yours might end up being in the second category for the following reasons 

Failure To Report The Injury Immediately 

One of the common reasons why most work-related injuries are denied is because many employees fail to notify their employers of the incident immediately. In most states, when an employee is injured at work, he/she is required to tell their employer of their injury within a few days, mostly four days after being wounded or when they learn of the medical condition. The primary purpose of reporting an injury soon is to give your employer enough time to investigate the circumstances behind the accident. If you fail to report it soon, your employer or the insurance company might deny the claim on the basis that it did not happen while at work. 

The Injury Might Not Be As A Result Of Work

For you to have a valid claim, your injury or ailment needs to have happened in the line of work. Hence your employer has a legal reason to deny your claim if external factors caused the injury or disease. For instance, if you suffer a heart attack at work due to your lifestyle choices, then your employer might deny your claim saying it happened at work but was not as a result of work-related causes. If you believe that your injury or illness is work-related, but your employer or insurance company denies it on this basis, then you can always consult a skilled workers compensation lawyer newton nj who will gather and analyze medical evidence as well as connect you to an independent medical expert to determine the cause of the injury. 

Failure To File The Claim On Time 

As similar as it might sound, reporting and filing a claim are different. Reporting an injury is notifying your employer as well as the insurance company about the injury while filing a complaint is taking legal action. It is vital to note that workers compensation claims are subject to the statute of limitation. In a majority of states, one is required to file a complaint within 30 to 90 days after the injury happens. Other reasons why your claim might be denied: 

– If the injuries are self-inflicted 
– Failure to seek medical treatment 
– When no one witnessed your injury 
– There is an inconsistency between your initial report and medical records 
– When you are not covered by workers compensation insurance 

In a nutshell, there are many reasons why your claim could be denied. The above make up some of the most common causes. Nevertheless, you don’t have to lose all hope as you can always appeal. For a successful claim compensation, it is advisable that you hire a skilled workers compensation attorney from the word go.



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