Common Reasons Why Workers’ Comp Claims Are Denied

If you are interested in filing for workers’ compensation after suffering an injury or illness on the job, you must understand that many workers are denied benefits every day. Employers and their insurance providers are only looking out for the best interest of the company, often denying as many claims as possible to avoid having to award significant payouts. Knowing the potential pitfalls of getting your claim denied can help ensure that you recover your entitled benefits without any problems.

The following are the most common causes of workers’ compensation denials:

  1. The injury was not reported in a timely manner. A typical reason why a workers’ comp claim is denied is due to the employee failing to report the injury immediately. Employers believe that if an injury was not reported right after the incident, then the injury did not occur. To avoid this issue, it is wise to report any injury which may lead to missed time from work.
  2. The injury occurred away from the workplace. Employers may often deny claims for injuries that occur outside the workplace since the incident did not happen on company grounds. According to Massachusetts workers’ compensation law, however, benefits are still available to workers who suffer an injury while in the course of fulfilling their work duties, whether at the workplace or off-site. This extends to situations where they travel on behalf of the company or drive to fulfill a work errand.
  3. There were no witnesses present. Employers typically worry about fraudulent claims. If an injury was not seen by a co-worker or a supervisor, the employer might be reluctant to believe the injured employee’s account of the accident. Alas, just because an injury was not witnessed does not mean that it did not happen.
  4. There was a pre-existing condition. If a worker had suffered an injury in an incident outside the workplace and then suffers further injury performing work duties, the insurance provider might attempt to deny the claim, stating that the worker had sustained the injury away from the job. However, if a worker does not have a pre-existing condition and this injury is worsened by an accident at work, this does not disqualify the employee from workers’ comp benefits.

If you suffered an injury at the workplace that requires legal assistance to file a workers’ compensation claim, contact our Erie, PA workers comp attorney at McNair Law Offices to request a free consultation today.