Workers' Comp Claim Denied? It Could Be Due To These Three Reasons

If you were injured while on the job, you should be able to use workers' comp to receive compensation for the damages you sustained. However, the application process does not always go smoothly. It's possible that your claim is denied and you are not sure why it happened. Here are some common reasons why your claim may have been denied.

An Insignificant Injury

When you use workers' comp, it is designed for workplace injuries that have caused a significant medical problem rather than a minor injury. If your workplace injury is something that was treatable by the time you left the workplace, it may be considered a minor injury and not qualify for workers' comp. Going to the doctor for the injury doesn't automatically mean you'll receive workers' comp either. Every workers' comp claim is treated on a case-by-case basis, with all factors related to the injury being considered.  

It is always a good idea to be treated by a doctor when in doubt, because injuries that are small may grow into something bigger. For instance, a small cut may become infected, which causes a much bigger problem. Neglecting to have the injury reported or treated could also cause a workers' comp claim denial.

An Injury Outside The Workplace

If you suffered a significant injury at the workplace, it should be a clear case for workers' comp. However, injuries that happen outside of the workplace can become confusing. In general, being injured during your commute to and from work won't be covered, but an injury while driving for work related purposes would count. If you are on your lunch break getting lunch when injured, that would not count.  If you were injured while being ordered to pick up your bosses' lunch, then that would count. When the activity outside of the workplace is dictated by your job, chances are you will receive workers' comp.

An Injury Wasn't Reported Timely

It is your responsibility to report all workplace injuries to your employer as soon as they happen. Of course, the exceptions would be if the injury left you incapacitated and unable to report it, such as being hospitalized.  Another exception includes if the injury wasn't apparent right away, such as due to a repetitive motion injury. If the delay in reporting fell solely on you, your claim may be denied.

Work with a workers' comp attorney if you are having problems with your legitimate case being denied. Reach out to a firm like Law Office of Joel A. Santos.