Four Reasons Your Workers’ Compensation Claim Has Been Denied

Binder of claims being handed

Four Reasons Your Workers’ Compensation Claim Has Been Denied

The workers’ compensation system has been put in place to assist employees when they sustain injuries in their workplaces. The primary objective of workers’ compensation is to compensate employees for the damages and losses so that they can return to their daily lives. You are in no doubt eligible for compensation after getting injured or developing a medical condition while in the workplace.

Unfortunately, some employers’ insurance providers often deny claims filed by injured employees even when they are viable. It usually leaves hardworking employees frustrated because they have to deal with the injuries and losses on their own. As such, every employee should take time to understand the reasons for the denial and hire a work injury attorney in Utah to help with the appeal process. It helps them to take the necessary precautions to make sure that they get compensation for injuries at work.

You can’t explain how you got injured

You should explain how the accident at work happened and how you sustained the injuries. For instance, if it was a slip and fall accident, you need to tell how you got injured. Otherwise, if you don’t have an explanation, you will most likely not be covered. Also, if you don’t explain how the accident happened, the insurance provider will assume that you are careless or clumsy. But if you fell because of a wet floor owned by the employer, you will be likely to get compensation.

Your application is late

In most states, your claim for compensation starts when you make submissions to your employer’s insurance provider. Usually, employees have about three months from the date of injury to make these submissions. Your doctor should complete some parts of the forms to be submitted. But you can still file for the claim after the 90 days but with a reasonable explanation for the late application. Most insurers deny workers’ compensation due to late application.

The injury did not happen at work

The damage must have taken place in the workplace for you to be eligible for workers’ compensation benefits. For instance, you could not qualify for these benefits if you got injured commuting for lunch or to the restaurant. But employees who get hurt when working at a restaurant or factory are eligible for the benefits. You may also get compensation if you were at a work assignment or event, like a company holiday.

There are no witnesses

Claim form

The insurance company might not compensate for the injuries if you don’t have a third party to verify the events. But you can back up your claim with a report from a medical professional if the accident happened while you were alone. The report should verify that the injuries were a result of your version of events.

These are some of the many reasons the insurance company denied your workers’ compensation claim. Since you now know the reasons, you can prepare yourself before you file another claim. Fortunately, you have a chance of appealing the decision if your application has been denied and you feel that it is legitimate. But make sure that you don’t walk this journey without the help of a lawyer.

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