What are Reasons Why a Workers Compensation Claim May Be Denied?

Serious injuries deserve experienced attorneys

Hillcrest Heights, MD workers compensation lawyers have the insight you may need

Hillcrest Heights, MD workers compensation lawyers know all too well that when a worker is injured on the job, they are entitled to file for workers compensation benefits. These benefits cover all medical expenses for the injury as well as pay the worker a percentage of their weekly wage in order to allow the worker time to recover from the injury.

Each state has its own workers compensation laws and regulations that must be followed. And many companies have their own procedures as to how workers compensation claims must be reported. The following are some of the more common reasons why an injured employee’s claim may be denied.

The injury was not reported in a timely manner.

As mentioned above, Hillcrest Heights, MD workers compensation lawyers will likely inform you that each state sets their own rules on how claims are to be handled. One of those rules is how many days a worker has to file a claim when they are injured. If the claim is filed after that deadline, it is very likely that your employer or their insurance company will deny the claim. This is why you should report any injury or illness immediately.

The injury did not happen while at work.

In order for an injury to be classified as a job-related injury, it must have occurred while the employee was engaged in required work duties. However, just because an injury occurred away from the worksite, that does not mean it should not be covered. For example, Hillcrest Heights, MD workers compensation lawyers may suggest that if you were performing an errand that was job-related when the injury occurred, that should be covered under workers compensation benefits.

There were no witnesses to back up the injured worker’s claim.

Some companies may try denying a claim just because there were no witnesses who saw the accident actually happened, however, this is not a valid reason for denial. As long as all of the other evidence backs up the worker’s claim – such as medical evidence of the injury – then the injury should be covered.

The employee had a pre-existing condition.

Depending on the medical condition or injury involved, an insurance company may deny a claim because the employee had a pre-existing condition. Hillcrest Heights, MD workers compensation lawyers may tell you that some of the more common conditions this happens with are arthritis, diabetes, epilepsy, and congestive heart failure. However, if the work injury aggravated the pre-existing condition, then the worker is entitled to receive workers compensation benefits.

The employee was under the influence of alcohol and/or drugs or the employee was engaged in horseplay.

If an employee was intoxicated or under the influence of drugs at the time of the accident, then the employer has every right to deny the claim. This also applies to an employee who was engaged in horseplay that resulted in the injury. An employer is not liable when an employee is injured due to their own misconduct.

Have You Been Denied?

A workers compensation denial does not mean you will not receive the benefits you may be entitled to. If you have been denied, contact Cohen & Cohen to set up your free consultation with experienced Hillcrest Heights, MD workers compensation lawyers.