Tried And True Attorneys Standing Up For The Injured Since 1965

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Photo of Craig R. Fishman

Tried And True Attorneys Standing Up For The Injured Since 1965

5 common reasons for workers’ compensation denial

On Behalf of | Mar 31, 2023 | Workers' Compensation |

If you’ve suffered an on-the-job injury, then you’re probably trying to find a way to offset the losses that have befallen you. This can seem like a monumental task given that you probably need extensive medical care at a time when you’re unable to work, and your inability to earn a wage can threaten your day-to-day stability.

You may be thinking that a workers’ compensation claim can help you here, and you’re right. If you succeed on your claim, then you can recover the benefits that you need to establish financial stability while you focus on treating your injuries and reclaiming your health to the point that you’re able to return to work.

That said, far too many workers’ compensation claims end up denied. Why? Let’s take a closer look so that you know how to effectively prepare yourself to pursue your claim.

Common reasons for workers’ compensation claim denial

A workers’ compensation claim can be denied for any number of reasons. Here are some of the most common:

  1. Your injury isn’t work-related: In order to successfully claim workers’ compensation benefits, you have to show that your injury was suffered at work. If there were no witnesses to your injury, your injury was pre-existing, or you were hurt while you were on a break or during your commute, then your claim may be a little more difficult to prove. Keep in mind that you may still have arguments in some of these situations, though, to show that your injuries were, in fact, suffered at work.
  2. The injury was caused by horseplay: Although you don’t have to show any negligence on your employer’s part before you can obtain workers’ compensation, you can’t successfully pursue one of these claims if your injuries were caused by your own joking, roughhousing, or horseplay that occurred at work. Therefore, you’ll want to be prepared to be specific in regard to what you were doing at the time you suffered your injuries.
  3. Medical treatment wasn’t sought out: If you’re seeking workers’ compensation benefits, then you’re claiming that you have workplace injuries that are so severe that they prevent you from working. That’s going to be hard to show if you didn’t seek out medical care after you were injured. It’s key to obtain medical treatment after being injured on the job and to follow your doctor’s recommendations for follow-up care. This helps establish a record of your care, your need for ongoing treatment, and how your condition impacts your ability to work.
  4. Not reporting the injury: When you’re hurt at work, you should report the injury to your employer as soon as possible. Any delay may give an indication that your injuries aren’t as severe as you claim them to be.
  5. Intoxication was present at the time of the injury: Any signs of intoxication will be used against you when you pursue a workers’ compensation claim. This is pretty straightforward, as your employer will argue that your injuries wouldn’t have been suffered if you had been sober and performing your job duties in accordance with your employer’s expectations.

Build the strong workers’ compensation claim that you need

You can face significant financial hardship after being injured on the job. But you don’t have to let yourself be subjected to these challenges. Instead, you can aggressively seek out the benefits that you need and deserve.

In order to position yourself for success, though, you’ll need to anticipate these common reasons for denial so that you can be prepared to avoid them. If you’d like help in that regard, then you might want to consider reaching out to an experienced workers’ compensation attorney for assistance in building your case.