If you are injured at work and file a worker’s compensation claim, sometimes that claim is denied or opposed by your employer. What are your options then?
Because employers and their insurance companies must follow state law when determining whether a worker’s compensation claim is valid, they are required to notify an employee if the claim has been denied within 21 days of the filing of the claim. The employer must submit a Notice of Denial to the employee. The notice must state which benefits are being denied and the reasons for denial.
Why Would My Employer Contest My Claim?
Your employer or its insurer can cite a number of grounds for denying a claim. Among those grounds are:
- The injury happened away from work: If your job does not require you to leave the workplace, if you are injured away from the workplace your employer likely will say the injury is not in the course of your employment as required by worker’s compensation law.
- The injury happened while traveling to or from work: The same rationale applies as above.
- Treatment or absence from work is not medically justifiable: If you have had sufficient time to heal from your injuries, your employer might contend that you no longer need to be away from work and receiving worker’s compensation payments.
- Late notice of injury: Every state requires timely notice of injury to the employer, and your employer might contend your notice was not timely.
- Treated with an unapproved medical provider: About half of all states let the employer choose who treats the employee’s injuries. If you choose a different care provider, benefits might be denied.
- No medical treatment: If you claim a workplace injury but do not seek medical treatment, your employer likely will challenge that claim.
- insufficient documentation that the injury is work related: Many progressive injuries, such as carpal tunnel and hearing loss, can be a function of aging or other non-work-related factors and so there must be proof that the injury was directly related to work.
- Pre-existing conditions: Obviously, these cannot be work-related and claims will be rejected if your employer believes you had a pre-existing condition.
- Intoxication: If your employer believes you were under the influence of alcohol or other substances when you were injured, your claim will be challenged.
- Horseplay or rough-housing: If your employer contends that you were playing around when you were injured, your claim will be challenged.
In these circumstances, you should contact an attorney experienced in worker’s compensation law to ensure you are not deprived of any compensation you might be entitled to.
If You Have Had a Worker’s Compensation Claim Denied in the Vidalia area, Contact the Personal Injury Lawyers of Smith and Tillery
If your worker’s compensation claim has been rejected in the Vidalia area, you should consult a personal injury attorney to determine what your rights are. The rejection might be improper and you could be entitled to compensation.
The lawyers of Smith and Tillery are experienced in worker’s compensation law and can assist you in protecting your rights and obtaining just compensation. You can reach us at (912) 537-3030 or through our online contact form.