3 causes of a workers’ comp claim denial

On Behalf of | Jan 30, 2023 | Workers' Compensation

Have you recently suffered a workplace injury? As a result, are your injuries preventing you from returning to work? Are you afraid your injuries are going to jeopardize your current and future employment? If you answered yes to all of these questions, then you should be sure you understand your employee rights.

Many employees are eligible for workers’ compensation benefits. These benefits allow injured workers to earn wages lost from their time away from work, pay medical bills and eventually return to work. Employees injured on the job don’t benefit from workers’ comp until they make a claim. 

Unfortunately for many people, a workers’ comp claim can be denied. This has prevented many people from returning to work and finding future employment. What causes a claim denial? Here are three possibilities:

1. Self-inflicted injuries

Workers’ compensation is a no-fault program. What this means is that an employee may have been injured because of something they did or from the negligence of a co-worker or employer, yet, they will still be eligible for benefits. However, these benefits don’t apply to injured workers who inflicted their injuries purposefully, which may lead to workers’ comp fraud.

2. Injuries incurred outside of work

Employees who work outside their office or who drive a work vehicle are eligible for benefits if they’re injured on the clock. However, workers who were injured on their own time are not eligible for benefits. This applies even if their injuries affect their ability to work.

3. Unreported injuries

For an employee to receive their benefits, they must report their injuries to their employer. Their employer can then file the proper paperwork to begin the workers’ comp claim process. However, without first reporting these injuries, then a worker won’t be eligible for their benefits. 

If you’re filing a workers’ compensation claim and you fear your claim could be denied then you should understand your legal rights