Why Your Workers Compensation Claim May Have Been Denied

Workers Compensation Attorney

Employees can get hurt in just about any workplace, from construction sites to offices, and can sustain a wide range of injuries. That’s why employers are required to carry workers compensation insurance. It can help pay for an employee’s medical expenses and lost wages following an accident. However, sometimes workers compensation claims get denied initially. If your claim has been rejected, don’t lose hope. Instead, learn about the various reasons why employers deny claims.

You Have a Pre-existing Medical Condition

When you see a doctor about your work injuries, you will likely be asked if you have any pre-existing medical conditions. If you do, your employer may try to argue that your injury is due to the pre-existing condition, not a work-related accident. However, as a workers compensation attorney from Rispoli & Borneo P.C. can confirm, many people have pre-existing medical conditions and that does not automatically disqualify them from workers compensation benefits. If your work accident exacerbated your pre-existing condition, you are still eligible for workers compensation benefits.

You Were Under the Influence of Drugs or Alcohol

Fault is not a factor considered in workers compensation cases. However, if you were under the influence of drugs or alcohol when you got hurt, you will no longer be eligible for workers compensation benefits. 

You Didn’t Report the Accident to Your Employer Soon Enough

If you get hurt at work and want to file a workers compensation claim, you have to tell your employer about the accident as soon as possible. In New Jersey, you are required to report your injury to your employer within 14 days of the accident. If you try to report the accident after that deadline, you may not be able to receive benefits anymore.

You Delayed Medical Treatment

Some employees who get hurt at work delay medical treatment to see if they will get better. However, if you plan to file a workers compensation claim for your work injury, you need to see a doctor as soon as possible. A doctor should evaluate your injuries and then recommend the appropriate treatment. If your employer and the insurance company find out that you waited to see a doctor, they may argue that you are not as hurt as you claim and deny your claim. Additionally, your employer will likely require you to seek treatment from an approved medical provider. If you see another doctor, your claim could get rejected.

You Didn’t Sustain the Injury While Working

In order to be eligible for workers compensation, you must have been injured on the job. However, you don’t necessarily have to be at your physical job site when you get hurt. For example, if you have to drive a vehicle as part of your job and get in a car accident, you may still qualify for workers compensation benefits.

If you need assistance filing a workers compensation claim, you should get in touch with an experienced workers compensation attorney as soon as possible.