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Why are workers’ compensation claims denied?

Individuals in Iowa who suffer an injury at work can suddenly find themselves struggling to make ends meet. Unexpected medical expenses, rehabilitation costs and lost wages can eat away at one’s savings and leave an injured worker worried about what the future holds for them. Fortunately, these individuals may be able to obtain financial relief through the workers’ compensation system. However, many of these claims are initially denied, necessitating an appeal.

There are a number of reasons why workers’ compensation claims are denied. One reason a claim may be denied is because the reporting of the injury and/or the filing of the claim failed to adhere to specified timelines. This highlights the importance of quickly reporting an injury or illness to one’s employer and taking action to file a workers’ compensation claim.

Another major reasons that these claims are denied is because employers successfully challenge them. Here, an employer may claim that the injury in question was suffered outside of work or, even if the injury was suffered at work, that it was the result of an employee engaging in horseplay. Related to these arguments are those claims that a worker’s claim lacks sufficient evidence to show that it is work-related. Medical evidence is therefore imperative in these cases, and injured workers should do everything they can to show that an injury was suffered while carrying out their specific job duties, or that a pre-existing injury or illness was exacerbated by their work.

Dealing with workers’ compensation claims can be difficult and stressful, especially when an initial claim is denied. Yet, by being legally prepared and developing strong arguments that are supported by available evidence, injured and ill workers may be able to increase their chances of success on either an initial claim or an appeal.