Worried that your workers’ compensation claim is going to be denied, even though you feel like you absolutely deserve it?
This does happen to employees all year long, and many are as surprised as you’d be if it happened to you. The key is to know why these denials happen so that you can work to avoid them. Below are five common reasons.
- The injury happened on the job, but it wasn’t work-related. For example, your spouse comes to visit you at lunch, and he or she accidentally trips you in the parking lot. You fall and break your wrist.
- The doctor you chose wasn’t within the proper network. You might have to go to another doctor, even if it’s not your primary option.
- You didn’t report it fast enough. If you try to report an accident that happened two months ago, officials may be skeptical that you were even injured at work in the first place. Always report accidents immediately.
- Your condition existed before you got the job. For instance, you claim that your job caused you to lose your hearing, but medical records showed you already lost your hearing before you were hired.
- You don’t tell officials and doctors everything that happened. It’s important to be open and honest, ensuring that all of the facts get out in the open. This way, an accurate assessment can be made.
If you do wind up getting denied, make sure you know what legal options you still have. In some cases, simple mistakes — like not providing complete information — can be rectified.
Source: Pay Scale, “5 Reasons Employees Get Denied for Workers’ Compensation,” Daniel Kalish, accessed Feb. 2, 2018