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Common reasons for the denial of workers’ compensation benefits

On Behalf of | Nov 30, 2021 | Workers' Compensation |

When you are hurt on the job, one of the things you may seek is workers’ compensation. Workers’ compensation is there to help you cover the cost of your medical care as well as to replace a portion of your lost wages.

There are times when workers’ compensation claims will be denied. Those reasons may not be fair to you and should be argued against. Here are five common reasons of a workers’ compensation claim denial that you can appeal.

  1. There isn’t sufficient medical evidence

The first reason for a denial may be if there isn’t enough medical evidence. If you didn’t seek medical treatment or waited before seeking it, there may not be good support for the claim that you’re making. Getting further medical treatment or examinations and submitting them may help you appeal a denial for this reason.

  1. Your employer claims that the injury isn’t work-related

If your employer claims that your injury wasn’t related to work, you will need to fight back against that with witness statements or with a medical document that states that the injury is linked to an event at work.

  1. Your employer claims the injury is related to alcohol or drug intoxication on the job

Your employer may claim that your injury is linked to intoxication and impairment, but you can show that impairment was not part of the problem if you have video, testimonies from others or statements from your health care provider.

  1. The insurance company places an inaccurate value on the cost of your injury and medical treatment

When the insurance company doesn’t think that the injury was severe enough to warrant coverage, such as if it thinks you didn’t need medical care or that you didn’t need time off, then it may deny a claim.

  1. The insurance company fails to hold up its end of the contract

Finally, there is the risk of a bad-faith claim in which the insurance company simply doesn’t approve the claim despite the requirements being met.

With the right legal advocacy, you can fight these common causes of workers’ compensation benefit denials. As someone who was hurt on the job, you deserve the opportunity to receive care and to have the financial support you need as you recover.