For What Reasons Might A Workers Compensation Claim Be Denied?

Most employees are of the opinion that in the event they are injured on the job all they have to do is fill out a workers compensation claim form and they are granted benefits. This is the norm but it is not a foregone conclusion that a claim will be honored, there are instances where the insurance company will deny paying what you know is a valid claim. When this happens the employee really has no option other than to turn to an El Monte workers compensation lawyer to enforce your rights as an injured employee. The question that begs for an answer is “why would a rightful claim be denied?” A few reasons follow.
There was no witness to when the supposed injury took place

* The report of the injury was delayed

* The medical report and the injury report are inconsistent

* The medical report indicates your system was compromised by illegal drugs or alcohol

* The claim was filed after the company had dismissed you or laid you off

Un-witnessed injury: There is little that you can do if the incident that caused the injury was not witnessed. You must however report immediately to your supervisor and should you discuss the circumstances of the accident later with others make sure you are consistent with the facts as you see them.

Failure to report: Insurers as well as employers will take the stance that if you didn’t report the incident immediately then you really were not hurt. This is one of the reasons for denial that an El Monte workers compensation lawyer sees frequently. You must never wait to report the incident no matter how bad you think the injury is. If you believe there are any chance at all of missing work or incurring medical bills, a complete accident report is a must.

Discrepancies: It is extremely important that all reports given to the employer as well as the doctor are the same, insurers will often deny the claim if they see that the reports differ considerably. When the accident is related to others; co-workers, doctors or the employer, be consistent with the facts.

Illegal substances: If, during a medical check-up after the report of an accident shows the presence of illegal drugs the claim will almost always be denied.

File a claim after termination: It is not unusual for an employee to suffer a workplace injury, be late in filing the report and in the interim be laid off or dismissed. The insurance company will view the claim as revenge. This is just one more reason why timely filing of the claim is so important.

If these or any other reasons for denial of claim are given to you by the insurer your first task should be to hire an El Monte workers compensation lawyer.

If you suffer a legitimate injury at work and your claim is denied you should consider hiring an El Monte workers compensation lawyer. Click here for more details.

Sharing is caring!