The Top Reasons Your Workers’ Compensation Case May be Denied

The purpose of workers’ compensation insurance is to provide injured or sick employees with funds to cover basic and injury-related expenses while they are unable to work. Unfortunately, the workers’ compensation system is complex, and while many cases can be handled without any issues, there are some valid claims that end up being denied. There are several reasons this can happen. Getting to know some of the most common reasons your workers’ compensation claim may be denied can be helpful.

Also, if you find yourself in this situation and need help, hiring an experienced and proven workers’ compensation attorney is the best thing you can do.

You Were Injured While Away from Work

To ensure you are eligible for workers’ compensation benefits, you have to have suffered the injury in the scope and course of your employment. According to the workers’ compensation law, benefits are only given to someone who is injured while on the job. When this happens, there is no proof or assignment of fault needed. All that you are required to establish is that the injury occurred while you were working and is connected to the work you did in some way. However, if the injury occurred while you were on a personal errand or at lunch, you will not be able to recover these benefits.

You Are a Independent Contractor

Even though an employer is required to provide their employees workers’ compensation benefits, there isn’t a requirement like this for individuals who are classified as independent contractors. Usually, the employer-employee relationship exists if a worker is performing services that are legally controlled by the employer, such as how and when it will be done. This is the case even when an employee is given freedom of action.

Independent contractors, on the other hand, can control the direct result of the work they do, but not the way the work is to be done. If you are an independent contractor, you are most likely not covered by workers’ compensation law and therefore cannot receive benefits if you are injured.

You Did Not File Your Workers’ Compensation Case within the Designated Time Period

According to workers’ compensation law, injured workers need to file, in writing, something called the First Report of Injury. This report must be filed within a specified amount of time, usually as soon as possible and no later than 30 days after the injury occurred. If you fail to do this, you may face different penalties, all determined by state law. Usually, the time limit beings to countdown on the day that the accident occurred and may extend to accommodate the payment of lost wages or medical bills.

You Failed to Receive Treatment from a Medical Provider Approved by the Workers’ Compensation Insurance Provider

When you are injured on the job, you don’t get to choose who provides treatment for your work-related injury. Instead, it’s up to your employer and the insurance company. You will get to choose the treatment provider from a list of approved doctors. As long as you choose one of the people on the approved list, the workers’ compensation insurance will cover the treatment. If not, benefits will likely be denied.

If you are in a situation where your workers’ compensation claim has been denied, contact our legal team at Scott J. Sternberg & Associates by calling (561) 687-5660. We can help you get the compensation you deserve.

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