Can the insurer deny my workers’ compensation claim?

On Behalf of | Feb 28, 2024 | Workers' Compensation |

Workers’ compensation is a system designed to give employees who suffer work-related injuries or illnesses the benefits they need to recover. It can even replace the wages they lost while recovering. In Minnesota, this system operates on a no-fault basis, meaning you do not have to prove your employer was liable for your injuries to get the benefits.

However, that does not guarantee a claim approval. The insurer may still deny your claim, but they need a legitimate reason for the denial.

Reasons an insurer may deny your claim

Remember, insurance companies will attempt to pay you as little as possible or nothing at all, so they will send an adjuster or another representative to investigate your claim. Here are some of the more common reasons an insurer might give to deny your workers’ compensation claim:

  • Your injury or illness is not work-related.
  • A pre-existing condition caused your injury or illness.
  • You do not have enough evidence to support your workers’ compensation claim.
  • You did not report the injury or illness immediately.
  • You did not cooperate with the investigation.
  • You failed to provide the information and documentation the insurer asked for.

Even though the insurer agrees that your injury or illness is work-related, they might try to downplay its impact on your life. They may say you do not need the treatments your doctor prescribed. Therefore, you need to report your injury promptly and document everything.

You have a right to appeal a denial in Minnesota

Just because the insurer denied your claim does not mean it is final, especially if you followed all the rules, reported the injury on time and submitted all the correct paperwork. Many workers have successfully appealed their denied claims and obtained the benefits they deserved.

If you disagree with the insurer’s reason for denial, you can file an appeal and try to get the workers’ compensation benefits due you. But, this time, make sure you do everything accurately.

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