Why Was Your Worker’s Compensation Claim Denied?

The goal of workers compensation law is to provide injured employees with financial coverage for medical expenses and lost wages after an illness or injury suffered while the employee was on the job. However, employee claims are not always approved. There may be instances in which a worker's compensation claim is denied. The following are some examples:

Your Injury Did Not Happen While You Were Working

This may seem like an obvious reason for a denial, but there is often some confusion about the definition of "injured while at work." To be eligible for worker's compensation insurance, your injury had to occur at your place of employment while you were working within the scope of your job. The only stipulation to this rule is if you were injured while you were out on a call or working at a different location. As long as you were on the clock and doing your job, you may apply for worker's compensation.

You may not get worker's compensation if your injury occurs on your lunch break or if you were out doing your own personal errands during the workday.

You Missed the Deadline

You have a set amount of time to file your worker's compensation claim to your employer. By law, you have to provide a First Report of Injury. This information has to be filed within a certain amount of time after your injury. This amount of time may vary from state to state, but you typically do not have more than a month to file this report. If you do not file your report before the deadline, you may not be able to receive your benefits.

You Used Your Personal Doctor for Treatment

While you can make a request to use your own doctor for your medical treatment, your employer will likely prefer that you use a doctor of their choosing to provide care for your work-related illness or injury. You can make a request to see your doctor, but your employer does not have to comply with your wishes. If you do not like the medical provider your employer chooses for you, you may be able to choose a different doctor from a list of approved doctors. If you still choose not to see one of the approved doctors and instead see your own doctor, you will most likely not receive worker's compensation insurance.

When you are hurt on the job, it is crucial that you follow the rules set by law and your employer if you want to get access to worker's compensation benefits.