Workers' compensation exists so that when workers like you are hurt on the job, they have the funds they need to cover medical expenses and a few personal bills. If you recently applied for workers' compensation but you were denied, you are owed a reason. The following reasons are some of the most common for denying benefits. These reasons can be fought legally, too, and each has its own legal approach.
Your Injury Is Not a Covered Injury
Sadly, this is probably the most common reason given for the refusal of workers' compensation benefits. In some cases, workers are left holding the bag because the companies providing the benefits were smart enough to very carefully and in great detail list what injuries were excluded and included in their policy. For most every other situation, the reason is very vague and not well-defined in the provider's policy, in which case, you can absolutely fight it in court (or settle it outside of court if you have hired a workers' compensation lawyer). You can try to fight it even if your injury is specifically included, especially if you can cite neglect on your employer's part, but you should be prepared for an uphill battle.
Your Injury Is Not Severe Enough to Warrant Workers' Comp
A hangnail is not severe enough for workers' comp. A missing body part is, as is the temporary loss of use of a previously fully functional limb. For the workers' comp provider to say that your injury is not severe enough to warrant the issuance of benefits is not reason enough. They run the risk of being so specific as to go against what their own policy says, so they try for the general excuse to avoid paying up. When your lawyer points out the severity of the specific injury, and that said injury is covered under their policy, they will have to pay up.
You Did Not Receive the Injury on Company Time
This is a real zinger, and often the excuse used when employees fail to file a claim right after an incident has occurred. The problem they see is that you had an accident, like a slip and fall, but you did not report any injury or pain at that time. You waited several days or weeks later, and now you want benefits. Ergo, the provider will argue that you received your injury outside of work and that you were never injured on company time or property. Proper documentation and medical records on your part will help your lawyer prove that you did indeed receive said injuries on company property and company time.
For more information, contact a firm like Gilbert, Blaszcyk & Milburn LLP.Share