No workplace is 100% safe. While some occupations are more prone to risk than others, any worker can suffer from an injury incurred in the workplace. Work-related injuries are particularly challenging because you may end up incurring medical bills, lost wages and even long-term health complications moving forward.
In addition, many workers have only one security blanket when they become injured at work: workers' compensation. If your workers' compensation claim is denied, you may have no other recourse for covering your medical expenses and lost wages.
Here are 4 common reasons why a claim for compensation can be denied, and what you should do about it.
1. The injury didn't occur at work
The most challenging aspect of workers' compensation cases is proving who was in the wrong. It's not uncommon for insurers and employers to try and circumvent liability when an injury occurs. One of the most common reasons why your claim may be denied is because the injury allegedly didn't happen at work (or as a result of work duty).
Unfortunately, it can be quite easy for employers to convince decision-makers that your injury wasn't work related. An employer may draw parallels between your personal life and work life so as to identify grey areas for denying a claim. If, for example, you typically engage in risky sports such as dirt bike racing, an employer may claim that an injury you received due to a fall at work was more related to your hobby than your job. This may result in a denied claim and lack of compensation for your troubles.
2. The injury was pre-existing
An employer (or their insurer) may also argue that you already had an injury before beginning work with them. They may try to use your medical records against you so as to prove their point and avoid payment of a claim.
3. The injury was reported outside the recommended period
Another common reason why claims are denied is because they weren't reported within established timelines. Some employers require that an injury incurred in the workplace be reported within a specific timeframe.
However, the reality is that some medical conditions take years to develop but can be traced back to their origin. This often results in many disputed claims.
4. Negligence of the employer
Finally, some employers may simply look for any reason to deny, delay or only partially honour your claim for workers' compensation. Employer negligence is quite common and is a big reason why you should seek the services of a compensation lawyer when seeking compensation for a workplace injury.
If your claim is denied because of the injury being non-work related, pre-existing or reported outside of the deadline, a lawyer can help you argue the case in your favour so you can receive the benefits you truly deserve. Their experience allows them to navigate available laws and documentation that may help your cause.