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Reasons for Workers’ Compensation to Be Denied

If you get an injury in the line of duty, the doctor advises you to remain at home and recover. It is time to relax and wait for those workers’ compensation checks to arrive! This is how workers’ compensation works in some situations. However, some cases result in a workers’ compensation denial.

Why was the workers’ compensation offer turned down? Every circumstance, injury, and even insurance company are different, but the following are some of the most common reasons as to why workers’ compensation can be denied:

The Accident Did Not Occur At Work

For you to be eligible for workers’ compensation benefits, your accident or sickness should have occurred due to the duties you performed in the line of duty. Thus, one of the most common reasons a workers’ compensation claim is dismissed is that the accident did not occur in your line of duty, or so the employer claims. Nevertheless, there can be a lot of grey ground in this sort of situation.

You Had An Injury Before

An insurance provider will easily reject your claim if you have pre-existing injuries. However, several job accidents exacerbate pre-existing conditions, putting you in a situation where you can no longer physically work like you previously could. Like the other cases, this is an example of why you ought to consult a lawyer.

Injuries Were Not Reported Promptly

There are deadlines in each state for reporting a job-related injury. In Arizona, you must notify your employer immediately after suffering an injury. However, as with many other aspects of workers’ compensation, things are not always as straightforward.

For instance, various injuries, such as occupational diseases and chronic stress injuries, develop over a long period. As a result, discovering these injuries and responding to them can take some time. However, insurance providers would gladly refuse a claim if they can find a justification to claim that you failed to disclose the injury promptly.

You Were Under The Influence When the Injury Occurred

Employers may deny workers’ compensation payments for a work-related accident for a variety of reasons. Should you sustain an injury while under the influence of alcohol or opioids, this is one of them. On the other hand, employers in Arizona are not allowed to randomly screen workers for alcohol and drugs following any work-related accident. As per OSHA guidelines, the employer will only perform these tests if there is the justification the intoxication was a factor contributing to the illness or accident.

You Did Not Access Medical Care For The Injury

Suppose you sustained injuries at the workplace but ignored them because it was not causing any significant discomfort or pain? Then, later on, about a few days later, you notice that something was severely wrong, and you require medical attention.

In such a case, the insurer may claim that you could argue that you feigned the accident or that it was not as bad as you claimed because you did not seek medical attention immediately. They may even raise concerns about the cause of your injury since you took too long to seek treatment. Furthermore, they may claim that you did not take appropriate measures to limit the severity of your injuries.

Other Reasons Your Claim Might Be Denied

  • Paperwork was filed after the statute of limitations
  • You do not have supporting medical documents
  • Your accident was unwitnessed

Seek Legal Help Following A Denied Workers Compensation Claim

You might not need a Workers’ Compensation attorney to file your claim, but hiring one would almost certainly improve the likelihood of succeeding. An experienced attorney will effectively walk you through the legal system. Besides, he/she will counsel you on the various steps and paperwork you will require to ensure your claim is successful.

Has the liable insurer denied your workers’ compensation claim? Contact the experienced Phoenix Workers’ Compensation Attorneys today at Snow, Carpio, Weekley to discuss your case.

Call Today! (602) 532-0700

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