If you suffer injuries on the job, you might be able to submit a workers’ compensation claim. However, if your claim does not meet specific requirements, including some policy timelines, your insurer might take advantage of your situation and deny you your benefits. It’s in your best interest to know why your employer or insurer is likely to deny you your claim so you can avoid it from happening to you or your family in the future. Here are five of the most common reasons workers’ comp claims get denied, along with tips on handling them better next time if you face these same challenges.
- Inadequate Documentation
To successfully file a workers’ comp claim, you must have all the appropriate documentation. That includes medical records, doctor’s notes, prescriptions, and evidence supporting why your injury happened in the first place. If any of these is missing or unclear, your insurer may deny your claim. If you do not provide all of the necessary information or paperwork, your insurer or employer may have the grounds for denying your claim.
You also want to ensure that you provide all documents as soon as possible so the adjuster can review them before there are gaps in coverage, which could lead to even more complications with filing a workers’ compensation claim. For comprehensive and accurate documentation that aligns with legal guidelines, you should work with an Experienced Workers’ Compensation Lawyer attorney who will help you create the most appropriate strategy to pursue the best possible outcome.
- No Direct Relationship Between Injury and Job Duties
For your claim to be successful, there must be a connection between the injury and job duties. An example is someone who suffers injuries while carrying something heavy or being on their feet all day. These are directly related to the tasks they were doing at work. If someone suffers injuries from an unrelated activity that was not part of their job like an injury one sustains when in an entertainment joint on the weekend, it may not correlate with any work-related activities.
However, suppose you sustain an injury from performing your assigned task (even if it’s related to another job) or performing your regular activities outside of work for the company. In that case, you might have a chance for success. However, to avoid your insurer taking advantage of the gray areas and denying a claim, you should always contact a reliable workers’ compensation lawyer. They will help sort out what exactly constitutes work-related so you can ensure your right to compensation under the law.
- Medical Issues That Are Not Relevant
If you cannot prove that the medical issue you are experiencing was due to your workplace injury, there is a high chance your insurer may deny your claim. Personal injuries that do not have a solid connection to the job, such as ones from a previous car accident or another source, may lead to the denial of your workers’ compensation benefits. It’s, therefore, crucial to be true to the self while being candid about any potential complications with your condition.
The best way to make a comprehensive case is to get in touch with an experienced lawyer who can provide more information on whether you have a viable chance and what steps to take next. Your lawyer can review the specific details of your injury and help you decide how to proceed accordingly. That way, you can take it easy while fighting for your rights, knowing that you have a professional watching over your needs.
- Not Enough Proof of an Injury Occurring
For a workers’ compensation claim to be successful, it’s crucial to provide enough evidence for the company to believe that you suffered injuries on the job. If you claim an injury but can’t provide proof of what happened at work or how your injury occurred, your claim might not be acceptable. It is essential to fill out a form and save all of the information from personal injury so that if anything goes wrong with your case, there will still be documentation of what happened. However, this may occur due to inaccurate records or missing records.
To file a workers comp claim successfully, document everything about the incident so there is no question about what happened, including witness accounts. It’s, therefore, essential to have a workers’ compensation lawyer at hand to ensure that you follow all the steps in filing a claim. A workers’ compensation attorney can help you understand your rights as well as prepare for any potential legal battles when dealing with cases related to workplace injuries.
- Failure to Follow Doctor’s Advice
If you have injuries on the job, it is important to follow your doctor’s advice. It is also essential to meet all your medical obligations, such as medical treatments, and attend all your scheduled appointments. If you fail to follow these instructions, your employer or insurer may deny your workers’ compensation claim. Also, the lack of seeking professional medical care for an injury within a reasonable amount of time after it happens may impact your ability to receive benefits.
Conclusion
Navigating through the process of workers’ compensation can be an overwhelming and confusing experience. However, the best way to avoid any issues with a workers’ comp claim is to work with an experienced workers’ compensation attorney who can help you understand the process and meet its requirements for your insurer to accept your claim.
