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Reasons Workers Compensation Claims are Rejected

Reasons Workers Compensation Claims are Rejected

It’s no secret that not all workers comp claims are successful, and it’s important that you familiarize yourself with all of the pitfalls before embarking on a costly and time-consuming exercise. The following are the most likely reasons for claims to be rejected.

Your Injury Happened Outside of Work

Whilst there is a grey area surrounding this rule, on the whole, successful workers comp claims must be following an injury that took place at work. This does not include traveling to and from work, or indeed injuries that occur whilst on your lunch break. If, however, you are attending a conference outside of your normal place of work, then you should still be eligible for workers comp.

You Failed to Employ the Services of a Work Injury Attorney

Having a reputable attorney handling your case will dramatically increase your chances of a successful outcome. At firms such as Workers Comp Attorney Metairie, attorneys will take all the hard work away from you and ensure that you secure the best possible compensation for the injury you have sustained, leaving you to focus on your recovery.

You Failed to Notify Your Employer Within the Required Timeframe

Once an employer has been notified of an accident that has happened at work, they are responsible for carrying out an accident investigation. Failure to notify your employer of your injury will mean that the employer cannot carry out their investigation which could hamper your case. Insurance companies will often claim that there is no evidence that the injury happened at work as the employer was not notified.

You Were Under the Influence

Your employer has the right to request a drug and/or alcohol test when a work injury occurs. If there is any evidence of these substances being in your system at the time of your injury, then your claim will certainly be denied.

You Failed to Obtain Medical Records Following Your Injury

If you think your injury is severe enough to warrant a claim, then it is your responsibility to see an approved medical provider to obtain medical records to support your claim. Your employer is within their rights to provide you with a list of medical providers that you can visit to support your claim.

You Missed the Deadline for Filing Your Papers

Missing deadlines and time limits on claims will give your employer good reason to reject your claim. Should you employ the services of a claims attorney then they will take care of all of this for you.

Your Injury was a Result of Horseplay or Practical Jokes

Starting a fight or engaging in roughhousing or horseplay at work will negate any claim that you subsequently want to make for injuries sustained during that time.

Your Injury is from a Pre-Existing Condition

Although this can be a grey area, insurance companies will do their best to dispute any claims made on a pre-existing condition. Of course, if this condition is made worse at work, then you still have a good case for a claim.

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