Submitting a workers’ compensation claim only to receive correspondence notifying you of your employer’s decision to deny you coverage can infuriate you. While they should include a reason for their decision, you might feel frustrated and hopeless.
When you understand some of the common reasons an employer can legally deny coverage, you may feel more confident about what to do next.
Non-compliance is one reason why your employer can refuse coverage. Even if you did suffer an injury at work, non-compliance with your employer’s policy can negate your benefits. For example, if you willfully participated in dangerous, negligent or illegal activity that resulted in your injury, your employer can deny your claim.
A denied claim can also happen if you sought treatment out of the network of your employer’s insurance coverage. Filing a claim too late, after the statute of limitations passes, for example, can also jeopardize your coverage.
If you suffer an injury at work and doctors find that a preexisting medical condition contributed to the circumstances, your employer may refuse to provide benefits. According to U.S. News, your employers can also deny your workers’ compensation claim if your injury did not happen at work.
Immediately after your injury, make it a priority to record your experiences. Articulate a timeline that describes what happened before, during and after your injury. Explain your injuries in detail and the likelihood of your recovery. Take pictures and ask for witness statements from anyone who may have seen what happened.
With the right information and your diligence, filing a workers’ compensation claim should result in relief for you while you recover and prepare to return to work again.