Many workers are eligible for workers’ compensation benefits after suffering from on-the-job injuries or illnesses – but obtaining those benefits isn’t always a straightforward process.
Denied workers’ compensation claims are all too common, and the appeals process can be lengthy. That can leave an injured or ill worker struggling to get the medical care and replacement wages that they need. By learning more about common reasons for workers’ compensation claim denials, you may be able to avoid them. Here are some of the most frequent problems workers encounter with their claims:
You didn’t file in time
It’s important to file a workers’ compensation claim within the statute of limitations. You have a year to file a claim from the date of your injury or three years from the discovery of an occupational disease – although it’s wisest to file your claim as soon as possible so that you can more clearly connect your injury or illness to your work activities.
You weren’t injured while working
The main thing to remember about workers’ compensation claims is that your injuries must have happened while you were working. This means that if you were driving to work as part of your usual commute and suffered a car accident, you likely won’t qualify for benefits. If you were driving as part of your job duties, on the other hand, you most likely would qualify.
Your injuries were intentionally self-inflicted
Workers’ compensation is a “no-fault” system that doesn’t consider whether you, your employer or someone else was negligent before awarding benefits. But, if your employer alleges that you purposefully inflicted your own injuries in order to make a claim, your benefits could be denied.
Your injuries didn’t cause serious harm
Some injuries don’t qualify for workers’ compensation. For example, hitting your knee on your desk and getting a bruise isn’t an injury that’s eligible for benefits simply because that’s unlikely to keep you from working or cause any long-term damage.
Understand your legal rights
Workers’ compensation claims are erroneously denied all the time. If you’ve been injured or suffering from a medical condition while working and your benefits are denied, then it may help to understand your legal rights.