5 Common Reasons Your Workers’ Compensation Claim was Denied

If you suffered a workplace injury, you are eligible for workers’ compensation benefits—no matter who was at fault for the accident. These benefits compensate injured employees for their losses (e.g. medical expenses and lost wages) while they take time off from work to heal.

Unfortunately, employers and workers’ compensation insurers often deny these claims—even if they are legitimate. Not being able to obtain workers’ comp benefits means injured employees must pay for their own medical bills out of their own pocket. Missing work to recover from an injury can make supporting the family and household extremely difficult.

The following are the most common reasons why workers’ compensation claims are denied:

1. You failed to report your injury right away – As soon as the accident occurs, you need to notify your employer as soon as possible. While injured employees in Georgia have 30 days to report the workplace accident, it is imperative to do so immediately. Insurance companies often assume that if an accident isn’t reported right away, the employee wasn’t really hurt.
2. You failed to receive medical treatment – Many injured employees make the mistake of waiting to see if the injury can heal on its own rather than receiving immediate medical care. But if they later attempt to file a workers’ compensation claim, without any medical records to support the extent of their injury, the insurer will claim that the injury is nonexistent.
3. You were under the influence when the accident occurred – When you go to the doctor for a workplace injury, your employer can request that you perform a drug test. If the test indicates that you were intoxicated by alcohol or drugs at the time the accident happened, your workers’ comp claim will be denied.
4. You have a pre-existing injury – If you had been injured or ill prior to starting your job and you reaggravate or exacerbate the condition while performing job duties, you are eligible for workers’ compensation. However, insurers will claim the cause is the old injury rather than the work tasks, resulting in denial.
5. Your employer disputes your claims – The employer could say that the accident didn’t occur the way you claimed it did. Since the cost of worker’s compensation coverage will increase when there is a claim on the policy, they will do their best to deny the claim and save money.

If your initial workers’ compensation claim was denied, do not give up. There is still a chance to correct or appeal the decision with the help of an experienced workers’ compensation lawyer.

For more information about workers’ compensation claim denials in Georgia, contact the Law Offices of William F. Underwood, III, P.C., today and schedule a consultation.