A denied workers’ compensation claim means missing out on medical benefits and a portion of your lost wages as you recover. It can have far-reaching consequences on your health and financial well-being.
For instance, you may struggle to afford doctor visits, surgeries, medication or physical therapy. The lack of proper medical care can lead to prolonged recovery times or even permanent disability. Additionally, the missed income can complicate your financial situation, especially when you can’t work because of your injuries.
Understanding why your workers’ compensation claim could be denied can help you address the potential issues and increase the chances of a successful claim. Here are the common reasons.
Missed deadlines
You must abide by the set deadlines when navigating the workers’ compensation claims process. Otherwise, you risk a denial. For instance, reporting your injury to your employer outside the 30-day legal window could harm your claim for workers’ compensation benefits.
Lack of medical evidence
Insufficient medical documentation can lead to a denied claim. There could be doubts that your injuries are related to a pre-existing condition, not a workplace accident. Insurance companies may also downplay the severity of your injuries if you lack sufficient medical records.
Injuries not covered
While you may be entitled to benefits even if you contributed to your workplace accident, the workers’ compensation scheme does not cover all injuries. These include injuries arising from horseplay, intoxication or self-inflicted harm.
Incomplete information on the paperwork and discrepancies in your statements can also lead to a denial. It explains the importance of clearly documenting your workplace accident to avoid inconsistencies.
Fortunately, most of these issues can be prevented with the proper guidance and legal assistance, paving the way for a smooth claims process.