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Workers Compensation / 12.13.2019

Workers’ Compensation: Why Was My Claim Denied?

Workers’ compensation insurance was created to help injured workers obtain the financial help they need after an accident—so claiming your compensation should be easy, right? Unfortunately, it isn’t always as simple as it should be. In fact, workers often hire workers’ comp attorneys for legal help when they have a claim; otherwise, they may not receive the full benefits they’re entitled to.

As much as we hate to believe it, workers’ comp insurers rarely have our best interest at heart, which means they may use specific strategies to deny or lowball valid claims. If your claim was denied, it’s important to determine why you weren’t eligible to receive compensation, and if the denial was unfounded, you may be able to enforce your rights to pursue the compensation you deserve.

Common reasons for workers’ comp denial of benefits include:

  • The claim was filed after the worker had terminated their employment
  • The claimant did not sign the medical authorizations allowing the insurance company to obtain the necessary records
  • There was no witness to the incident that caused your injury
  • The injury was reported too late
  • The accident report and medical records do not align
  • The employer disputes the claim
  • The injury is not compensable
  • The injury did not require medical treatment
  • There are disputes over whether or not the injury was work-related

If any of the above-listed circumstances was true in your case, and your claim was denied, you may still be able to obtain compensation. Unfortunately, insurers often look for reasons to deny claims whenever possible in order to save their bottom-line. In these big companies’ efforts to cut costs, however, injured workers often feel the brunt of their ruthless denials.

Luckily, the denial of your workers’ comp claim isn’t necessarily the end of the road. When you received your denial notice, it probably explained why your circumstances didn’t qualify for benefits, and if that reason was a simple matter (like that of misplaced paperwork), you may be able to fix the issue with the help of a claims adjuster. Or, you may be able to appeal the denial with the help of a skilled legal representative. Our team at Richard Schwartz & Associates Injury Lawyer, P.A. has ample experience working with workers’ compensation cases, and we know what it takes to obtain maximum benefits, even in the face of a denial. However complex or problematic your case may seem, our firm is here for you.

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