There are no guarantees that a worker's compensation claim will be paid. When you file, your employer's insurance company will review the circumstances surrounding your accident and decide if it will pay. If you receive notice that your claim was denied, the company will include an explanation as to why. Here are some of the most common reasons for a denial.
Illegal Drugs and Alcohol
If you were taken to the emergency room following your accident, there is a good chance that a drug and alcohol screen were conducted. If your medical records indicated drug or alcohol usage, the insurance company has the right to deny your claim.
You and your worker's compensation attorney can fight the denial though depending on the circumstances of your accident. For instance, if your accident resulted due to the carelessness of a co-worker, you can argue that your usage had no impact on the details of the accident.
There is no requirement that your work-related accident had to occur in front of witnesses, but it can help your case. However, you should be aware that the insurance company will use this as a reason to deny your case. In the event this happens, all is not lost.
Your worker's compensation attorney could argue that you immediately reported the accident after it occurred. Your attorney could also legally request surveillance video that might have captured your accident. He or she could also use your medical records to show that you suffered an injury that was more than likely the result of an injury suffered on the job.
One of the most difficult situations that could lead to your worker's compensation claim being denied is filing after you have been laid off or fired. It is not entirely impossible that you did not get a chance to file your claim until you were dismissed from your job, but from the insurance company's viewpoint, it can look suspicious.
If your claim was denied because of the timing of your claim, there are some things you can do. One of the first is to rely on your medical records to show that you were truly hurt. You can also rely on witnesses to show that you did have an accident on the job.
Your attorney can decide which defense would work best for your specific situation. The key is to get your attorney, one like Kenneth R Schuster And Associates PC, involved in the process as early as possible.Share