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Common reasons for workers’ comp denials

On Behalf of | Apr 25, 2019 | Uncategorized

If you work in the construction industry in Des Moines, you know that you have a dangerous job. You probably even know a least a few people who have suffered both minor and severe work injuries.

While you might have avoided a workplace accident so far, it is impossible to predict what will happen on the job tomorrow or the next day. You could fall off a ladder or scaffolding, be electrocuted by a faulty power tool, or a coworker might drop something from the floor above that hits you in the head.

If an accident does occur, do you know what to do? Do you know the steps you should take to file a workers’ compensation claim? Do you know what mistakes to avoid so that you do not receive a claim denial? Here are a few of the most common reasons why workers’ compensation claims are denied.

You didn’t notify your employer in time

If you suffer an injury on the job, you should report it as soon as possible to your supervisor. It is usually best to report the injury the day of its occurrence or the next day. In addition, you should give notification in writing in order to start an evidence trail in case the insurer denies your claim.

You didn’t file the claim in time

Once you give notice of your injury to your employee, you typically have about 30 days to file a workers’ compensation claim. If you miss this deadline, it could result in an automatic denial.

Your boss is denying the claim

Another common reason for a workers’ compensation claim denial is that the employer is disputing the claim. For instance, you boss might tell the insurer that the accident occurred outside of work or some other reason that results in a disqualification for benefits.

You did not receive medical treatment

In most cases, you have to receive medical treatment for the work-related injury to qualify for workers’ compensation benefits. If you did not see a doctor or receive any kind of treatment for the injury, the insurer will probably deny the claim.

There is not enough evidence

When you file a workers’ compensation claim, you will have to provide a certain amount of evidence of the injury. For instance, you may need to provide medical records that prove your injury. Also, you might have to provide time sheets that prove you were on the clock at the time of your injury. Without sufficient evidence, you could receive a denial of benefits.

If you have suffered a workplace injury, you might be able to file a workers’ compensation claim for compensation for medical expenses and lost wages. If your claim is subsequently denied, do not give up. You may be able to appeal the decision through legal channels and receive the benefits you deserve.