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Workers’ compensation denial: Reasons and next steps

| Jul 11, 2018 | Uncategorized

The denial of a workers’ compensation claim is a big deal, as this will add more stress to an already bad situation. When you’re trying to recover from a serious workplace injury, the threat of not receiving the benefits you need is the last thing you need.

While you hope that your workers’ compensation claim is immediately approved, thus allowing you to receive financial assistance as you recover from your injury, you should never assume this will happen.

If you receive a denial letter, the first thing you should do is find out why. The letter will outline this in detail, so make sure you read it from beginning to end (perhaps more than once).

Some of the more common reasons for a workers’ compensation denial include:

  • Claim was not filed in a timely manner. You only have so long to file a claim for benefits, so you need to do it as quickly as possible. To avoid trouble, strive to file a claim within several days of your accident.
  • The injury was not reported to your employer. You need to let your employer know what happened as soon as possible, preferably the same day as the accident.
  • Your employer disputes your claim. You know that you were injured at work, but your employer fights back by saying that the accident happened on your personal time.
  • You did not receive medical treatment. You must obtain medical treatment following the accident. Not only does this help you when filing a workers’ compensation claim, but it’s also critical in regards to making a fast and full recovery.
  • There’s no evidence that you suffered the injury at work. You need to prove that you suffered an on-the-job injury, as opposed to getting hurt somewhere other than your place of employment. There are many types of evidence you can use to support your case, e.g., surveillance footage and witness statements.

Is an appeal possible?

If you receive a workers’ compensation denial letter, it will include instructions on how to file an appeal. You are not required to do so, but if you want to receive benefits an appeal is the next step in the process.

Follow the steps down to the last detail, as this will improve your chance of having the initial decision overturned. If you have a legal right to collect workers’ compensation benefits you don’t want to give up until you receive the money that is owed to you.


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