Why A Workers’ Comp Claim Could Be Denied

Filing a workers’ compensation claim is often a relief because you know financial help is on the way. Unfortunately, many workers’ compensation claims are denied and the employee doesn’t understand why. If your claim was denied, you can fight back with the help of a workers’ compensation lawyer, but you’ll need to know why it happened. The following are a few of the more common reasons why.

The Injury Didn’t Actually Occur at Work

One of the stipulations of receiving workers’ compensation is that the injury must have occurred while you were at work and performing your work-related duties. This is often easy to prove because witnesses were around and can vouch for the fact, but sometimes this isn’t the case. If your employer or the insurance company claims that you weren’t at work when your injury occurred, the claim could be denied.

You Failed to Notify Your Employer

There is a certain time period that an employee has to notify his or her employer of the injury. Most employers have some kind of policy in place that specifies how an employee should address a job injury. The state also has rules on how long a worker has to report their injury. If you don’t notify the employer on time or at all, your claim could be denied. Sometimes you assume your employer knows because everyone is talking about it or the employer was walking by when the accident happened, but you should never assume anything.

You Didn’t Receive Medical Care

Not every injury requires medical attention, and if yours didn’t, then you don’t qualify for workers’ compensation. This type of insurance is meant to compensate you for medical bills related to recovering from your injury, so if those medical bills don’t exist, your claim is most likely going to be denied.

You Were Intoxicated When the Accident Occurred

Being intoxicated at work carries several consequences, with one being that you might forfeit your right to workers’ compensation if you are injured. If intoxication is the cause of the accident, your claim would most likely be denied.

You Engaged in Roughhousing

Most company policies clearly state that roughhousing is not allowed. If you started a fight, engaged in roughhousing or horseplay, or were playing a practical joke when your injury occurred, your workers’ compensation claim may be denied.

Call a Personal Injury Firm for Help

Under state law, work injuries are almost always covered under the employer’s workers’ compensation insurance. If your employer does not want to pay out your compensation benefits, or you have difficulty obtaining those benefits, you should immediately contact an experienced attorney, like a NY workers compensation lawyer from a firm like Polsky, Shouldice & Rosen, P.C.