Three reasons your workers’ comp claim may be denied

On Behalf of | Jun 3, 2024 | Workers' Compensation |

When you suffer an injury or get sick because of your job, workers’ compensation acts as your crucial lifeline toward financial assistance and medical care. However, like any other insurance claim, securing this compensation is not always straightforward and getting a denial is always a possibility. This can leave you grappling with both health issues and financial uncertainty.

Knowing the common reasons for getting a denial is an important first step. It puts you in a stronger position to successfully navigate the process and secure the benefits you truly deserve.

You have incomplete documentation

Having complete documentation is key to avoiding claim denials. When you file your claim, remember to detail every aspect of the workplace accident and the injuries you suffered. Make sure you include precise dates, clear descriptions of what happened and all your medical records. Even one missing piece could jeopardize your claim.

Your injury may not seem work-related

When the connection between the injury and your job duties is unclear, disputes from your employer or their insurance company could arise. They could argue that the injury did not happen during work or was unrelated to your employment activities. To prevent this issue, make sure that your claim includes detailed descriptions of the incident and how your work environment or tasks directly contributed to what happened. The more specific you can be, the stronger your case.

You have preexisting conditions

It is common for insurers to suggest that your current medical issues are not due to a workplace incident but stem from previous health conditions. While having a preexisting condition does complicate your claim, this does not mean that all hope is lost. To counter this, provide detailed medical records that clearly differentiate your work-related injury from any preexisting conditions. Statements from your doctor detailing the specific causes of your new injuries compared to your past medical issues can be incredibly helpful.

Processing workers’ compensation claims can be intricate, but knowing what to expect and how to prepare can help you support your claim effectively. By understanding the common reasons for denials and enlisting legal assistance, you can proactively address these issues right from the start.

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