My Workers’ Compensation Claim was Denied, What Can I Do?

Rispoli & Borneo P.C.

Workers Compensation Lawyer

Employees who recently received notice that their workers’ compensation claim was denied, may wonder why this decision was made and how they can change it. The insurance company for the employer may deny the injury claim for several reasons. In some cases, the reason for denial is simply unjustified. This is where an attorney can be helpful, as he or she can see to it that your rights have not been violated when the workers’ comp claim was processed. A legal team can help you appeal the denied claim, to receive the benefits you need in order to get better.

Reasons for Denied Injury Claims

When an employee gets hurt while at work, it is imperative that they take all the steps necessary when handling the situation. For example, the employee must report the injury accident to their employer within a reasonable time-frame, and fill out paperwork to officially document the incident. If medical attention is needed, then it should be sought that same day. If an employee decides to wait and see if the injuries heal on their owner first, may be risking their chances of receiving workers’ compensation benefits.  

Here are common reasons for why a claim may be rejected:

  • No Witnesses to the Accident: it is often advised that the employee identifies witnesses after the accident, as evidence that the incident happened. If emergency care wasn’t needed or there weren’t any coworkers around at the time, the insurance company may fight the reliability of the claim.
  • Employer Did Not Seek Medical Care: an employee must get looked at by a doctor after the accident, as a way to have a starting point for when the injury was first examined by a doctor. A medical evaluation is a major component of proof for the employee’s injuries. Without medical documentation, filing for workers’ compensation benefits may be futile.
  • Pre-Existing Conditions: the employer’s insurance agency may deny the claim if the workplace injury is similar to or could have stemmed from a previous health condition. Detailed medical records can help show how the injuries were work-related, and not because of something that happened in the past.
  • Under the Influence: a blood/urine test that is positive for drugs or alcohol, may cause the employee’s claim to be denied. In the eyes of the insurance company, the worker may have caused the accident to happen due to being under the influence.

Seeking Help from an Attorney

It isn’t necessary that an injured worker gets assistance from a legal professional. However, without help from a workers compensation lawyer Abingdon, VA turns to, an employee may not realize that their claim had been mishandled, their employer committed retaliation, or that they have the option to appeal the claim denial. It may be in the worker’s best interest to get legal representation from the start. Please contact a law firm right away, so we can get started working on your claim.

Thank you to our friends and contributors at The Law Offices of Mark T. Hurt for their insight into workers compensation and denied claims.