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Eight Reasons Why Insurance Denied Your Worker’s Compensation Claim

When you have been injured at work, you expect worker’s compensation to take care of your medical bills and the damages you have suffered. It can feel like devastating news if your claim is denied. If you are confused by why your claim was denied, speak with a worker’s compensation lawyer in Pheonix to discuss your options.

Common Reasons for Denial of Worker’s Compensation Claims
There are many reasons that your claim may have been denied. Below we will discuss several of them. In some of the descriptions, you may recognize the reason for your own denial.

1. Your Employer Disputed Your Claim

It is possible that your employer disputed the facts encompassing your case. Your employer may believe that your injury did not take place on the job or that the circumstances of the injury were misconstrued. They may also claim that you are not eligible for worker’s compensation.

2. Late Reporting

Your claim may have been denied because your injury was not immediately reported after it took place to your supervisor or your employer. There are timelines that must be adhered to when filing a worker’s compensation claim.

3. Missed Deadlines

When filing for worker’s compensation benefits, it must be filed within a specific time frame. These are very strict in Arizona and are only extended in rare cases when the injured person is incapacitated and unable to meet the deadlines.

Workplace injuries must be reported within thirty days of the injury’s discovery. After that, the employee has one year to petition the Industrial Commission of Arizona for worker’s compensation benefits.

4. Employee Misconduct

If it is believed that you are at fault for your injuries, you may have received a worker’s compensation denial. This denial could be because drugs or alcohol were suspected of having contributed to the injury or that you were horsing around, and this caused the accident. In these cases, worker’s compensation benefits will not apply.

5. Pre-existing Conditions

If the worker’s compensation insurer believes that a pre-existing health issue contributed to the actual cause of your accident, it may deny your claim. The denial can possibly be contested, so speaking to a worker’s compensation attorney may be a necessary next step.

6. Independent Contractors

Sometimes, independent or freelance contractors are not eligible for the same benefits as regular employees. This job status could disqualify you from benefiting from a worker’s compensation claim.

7. Off-Site Accident

When an injury takes place away from the office or job site, it can be challenging to determine if it is related to the job. Often, in an attempt to not pay benefits, the worker’s compensation claim will initially be denied because it is complicated to prove whether the injury was work-related or not.

8. Lack of Witnesses

When there are no eyewitnesses present, it may be difficult to validate your version of the events leading to the accident. While this does not mean your injury did not happen the way you said it did, as unfair as it seems, it can still be a reason that a worker’s compensation claim can be denied.

When to Seek Legal Counsel

Immediately, in short. If you are injured at work, you should immediately speak with a worker’s compensation attorney in Phoenix to guide you through the complicated process. If your claim has been denied, talk to an attorney about appealing the decision. The team at Surrano Law Offices has experience fighting for worker’s compensation benefits and is ready to help you through this challenging process.