Can Workers’ Compensation Claims Be Denied?

No good comes from being injured at work. In addition to the pain of the injury itself, you may be unable to work while you recover. You may struggle to meet regular monthly expenses and also accrue new medical bills. A serious injury can make your life feel out of balance, but the knowledge that your employer has workers’ compensation insurance may be one comfort during this difficult time.

Because your injury happened at work, you may expect that you will receive workers’ compensation benefits to help you manage your expenses. This is why news of a denied claim can be devastating.

Why might an insurance carrier deny a worker’s benefits?

Workers’ compensation claims can be complicated. There are numerous steps that you must complete correctly, and because of your injury, it can be easy to make mistakes, miss deadlines or overlook details along the way.

Your employer’s workers’ compensation insurance carrier could deny your claim if the carrier believes:

• The injury is not work-related
• The medical treatment was not necessary
• The injury is not severe enough to prevent you from working
• You did not use your employer’s preferred doctors
• You did not properly report your injuries
• Other errors were made

What should you do next?

It can be discouraging to find out that the insurance carrier denied your initial claim. However, this is not necessarily the end of the road.

If the insurance carrier denied you benefits, you may file an application for an informal hearing with the Division of Workers Compensation. An informal hearing may be appropriate for simple disputes, like the amount of temporary or medical benefits. However, formal claims may be more appropriate for complicated disputes.

As an injured employee, you have rights. If you were injured at work but are being denied workers’ compensation benefits, it may be necessary to protect your rights. The best way forward will depend on your specific situation.