Workplace injuries are an inevitable part of doing business, but employees often end up bearing the full burden alone. Workers’ compensation offers a simple way for injured employees to get the care and compensation they need without exposing employers to expensive personal injury cases.
Unfortunately, workers’ compensation claims do not always go as smoothly as planned. If your claim was denied, you’re likely confused and unsure about what comes next. Get the help you need by calling Reeves & Mestayer at 228-374-5151.
You Waited to Report Your Injury
Whenever you get hurt at work, it is important to report your injury as quickly as possible. This allows your supervisor to check the scene of the accident, identify any mechanical issues, and retain any evidence. It also allows them to get information from anyone who witnessed the accident. If you wait days or weeks to report the injury, they may have no way of proving that the accident occurred or that your injury was work-related.
No One Saw the Injury
To be clear, even if no one saw you get injured, you still should receive workers’ compensation for an injury that happens at work. However, some insurance companies use this as a reason to deny a claim, knowing that many employees will not fight back. If your claim is denied because there were no witnesses to the accident, you can push back and ask for the compensation you are owed.
Your Injuries Don’t Match Your Accident
The workers’ compensation insurance provider will look closely at your accident claim, your medical reports, and your statement of events. If there are any discrepancies between your reports and your medical documentation, that may raise a red flag and lead to your claim being denied.
For example, if you say that caught your hand in a piece of heavy machinery but your most serious injuries are to your lower extremities, they will wonder if you are falsifying your claim. If you are claiming serious pain and extensive limitations but your medical reports don’t show any type of serious injury, that will also make them wonder.
Your Injury May Have Been Due to Drugs or Alcohol
The vast majority of employers require that injured employees take a drug and alcohol test before they receive workers’ compensation benefits. Depending on the circumstances of the accident and your state’s laws, you may or may not be able to receive benefits if you were under the influence at the time of the accident.
Testing positive for drugs and alcohol could lead to your claim being denied. Even if you still receive workers’ compensation benefits in this situation, you should expect to be terminated. This is the policy at most companies.
You Won’t Cooperate with the Company
You and your company both have to fulfill certain obligations as part of the workers’ compensation program. On your end, you are expected to report the accident in a timely manner, go to an approved physician promptly, and follow your doctor’s treatment orders. If you fail to provide requested documentation, skip doctors’ appointments, and refuse to keep your workplace up to date on your progress, their insurance company could deny your claim. After making your claim, ensure you know what your obligations are to avoid hurting your claim.
The Injury May Not Have Occurred at Work
If there is any reason to believe that your injury did not occur at work, expect your claim to be denied. Again, your claim being denied for this reason does not mean you are out of options. In some situations, it just means that the insurance company is grasping at straws and looking for a reason to avoid paying out your claim. Be ready to talk about your accident and injuries in detail to corroborate your claim and fight for the compensation you are due.
Get Help with Your Claim with Reeves & Mestayer A workplace injury can be inconvenient and frustrating, but you don’t have to navigate a claim denial alone. We can help you if your workers’ comp claim has been rejected. Let’s set up a time to talk and explore your options. Reach out to us online or give