Main Reasons Why Your Workers’ Compensation Could Be Denied

We have covered in the previous articles that there is an eligibility requirement before you can be considered, well, eligible for claiming a workers’ compensation benefits.

Workers' compensation

Let us review this eligibility requirements briefly:

  • You should be classified as an “employee”.
  • Your employer/company should have a workers’ compensation insurance.
  • Your injury should be work-related.
  • You should filed for a workers’ compensation claim on or before your state’s allotted deadline.

Most likely, you will pass the four eligibility requirements. Yet, just because you are eligible does not mean you will automatically get your workers’ compensation. Your employer and insurance company would like to know if your case is truly work-related, or if your case falls within the range where you should be given workers’ compensation benefits.

In other words, even though you are eligible, they may still refuse (or deny) to give you your workers’ compensation benefits. Here are the main reasons why your workers’ compensation claim could be denied (and what you can do about it):

1. You did not report your injury immediately

This is perhaps the most common reason why many employees do not get their workers’ compensation benefits. When you don’t report your case immediately, your employer and insurance company may assume that your injury isn’t serious enough that you “shrugged it off”. Also, remember that your state has a deadline for reporting – if you don’t submit within the deadline, you will lose your chances of claiming your workers’ comp benefits,

Solution:

Simply report your injury immediately. If you think your injury is serious or will affect your work, report it to your supervisor or file for an accident report. That way, you get to secure your claim – at least for this regard.

2. Your injury lacks (or have no) witnesses

Sometimes, it’s possible that you got an injury while nobody is around to witness what happened. For instance, you got injured while working in a heavy machinery inside a factory, but at the moment of the incident, you are the only one in the place. Another example: if you work using mainly your hands and you developed the Carpal Tunnel Syndrome over time, probably no one’s there to witness you gaining that condition. There’s nothing you can do about that, but be sure to tell your co-workers and supervisors right away. But because of our increasing technology, perhaps your best “witness” is the CCTV camera – if it took a good shot of your incident, it can be your great asset when filing for workers’ comp claims.

Solution:

Be sure to have someone around you when you’re working. Besides, we usually have co-workers helping us side-by-side, anyways. Also, make sure you are in a vicinity of a CCTV camera (and be sure they work). If your injury is road-related, you can have bystander witnesses as your, well, witness for your injury.

3. Mismatched accident report and medical records

If you reported your accident as this, but told your doctor otherwise, this will cause discrepancies in your case – hence, your employer and insurance company may distrust you, and for a good reason.

Solution:

Tell your doctor about your case based on how you reported your case to your supervisor. If you don’t do so, discrepancies will occur and your case will be less reliable, which may make your employer or insurance company to deny your claims.

4. Your medical record shows that you have an illegal drugs present in your body

As the point states, if your medical record shows that you have an illegal drugs or substance present in your body, your workers’ comp claim will most definitely be denied.

Solution:

Simply stay away from illegal drugs and substances. To begin with, it mostly causes you to do harmful thing to yourself and others.

Conclusion

Now that you know the main reasons why your workers’ comp claim could be denied, your solution is simple: to avoid doing what’s in the list.

If you need any legal help, be sure to talk to our LG Law Offices lawyers. We have the best and most passionate workers’ compensation lawyers who’s willing to help their clients get the most of your workers’ compensation benefits! For more information, you may visit our official website, https://lglawoffices.com/workers-compensation/los-angeles-ca-90012/ .

Shares

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.