4 Common Reasons Workers Compensation Claims Are Denied

24 October 2016 by Jonathan Phillips

Workers compensation is a type of insurance that employers must carry to protect employees in the event of a workplace injury. If you are hurt at work, you can file a workers compensation claim to cover the costs of medical treatment and lost wages. But there is a protocol to follow, and making a mistake can result in your claim being denied. Some of the most common reasons for a workers compensation claim being denied include:

Failure to Report the Injury 

When you're hurt at work, it is important to report your injury in a timely manner. Ideally, you should notify your supervisor of what happened as quickly as possible. Laws vary from state to state, so find out the statute of limitations for reporting injuries in the area where you live. If you do not report your injury within the time frame mandated by law, your employer's workers compensation insurance company may deny your claim.

Seeking Treatment from an Unapproved Medical Provider

In many states, the law allows employers to select a doctor or clinic to treat workplace injury cases. If you live in a state with this law, you are required to see the medical provider selected by your employer if you have a workplace injury. Being treated by an unapproved medical provider may be grounds for your workers compensation claim to be denied. Before seeking treatment for your workplace injury, speak with your supervisor or the HR department to find out if you need to see a specific provider for treatment.

Inadequate or No Medical Treatment

In order for a workers compensation claim to be approved, there has to be proof of medical treatment and medical records showing your injuries and how long they took to heal. If you do not see a doctor after getting hurt or if you fail to go to your follow-up appointments as you recover, there is a good chance that your claim will be denied no matter how much work you may have missed.

Intoxication

After a workplace injury, many employers will require a blood test to see if the employee was under the influence of drugs or alcohol when the injury occurred. If your blood test shows that there was any drugs or alcohol in your system at the time of injury, the insurance company may deny your workers comp claim since they may think that intoxication was a contributing factor to the injury. 

For more information about workers comp cases, check out websites like http://www.lovettlaw.com/.

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