When filing a workers compensation claim, the goal is always to have it approved. However, not everyone is met with this result. While there is no way to deny-proof a claim, understanding some of the more common scenarios that often lead to this outcome may be able to help you avoid a denial for your claim.
Failure To Notify
When you are injured on the job, it is your duty to report your injuries to your employer immediately. If you fail, or have failed to do this, you are increasing the chance of your claim being denied. All states have a mandatory period by which all incidents of injury must be reported, such as 30 days.
What some people fail to understand is that if you report the injury after this period, your employer may no longer be legally responsible for your injures. Speak up right away to avoid this outcome.
Never withhold any pertinent information surrounding the accident. This mistake may be interpreted as deception and can result in your claim being denied. Some people will leave out information if they believe it somehow implies that they may have been partially responsible for their injuries.
For example, maybe they were wearing high heels when they slipped and fell. Provided this was an employer approved footwear option, this would not be a detail that places fault on the employee. However, it is important information that the case reviewer would want to know. Be upfront and honest and don't leave anything out.
Not Following Medical Orders
Workers compensation is meant to serve as temporary financial assistance to aid employees during their time of recovery. It is not the same as disability, which is meant to be a more long-term assistance option. For this reason, a full recovery is always the end game and it's up to you to follow the orders of your doctor to accomplish this.
If you are not making your appointments, failing to take medication or overlooking any other orders, your claim could be denied. When a case reviewer sees this type of behavior, it puts into question the severity of your injuries. For instance, if you aren't taking your medication then your injuries can't be as bad as you say. Always follow doctor orders as your health and your claim depend on it.
An attorney, such as Townsend, Richard, can help you avoid these scenarios as well as other denial hiccups they may arise.Share