Three Common Reasons Why Your Workers’ Comp Claim Was Denied

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If you have endured a work-related injury, then you may have a workers’ compensation claim.  However, even if you suffered an injury at work, your claim can still be denied. Claims must meet certain criteria under the law, and a failure to meet those requirements can result in a denied workers’ comp claim. Claims can also be denied for questionable reasons as well.

  1. Failure to report the injury on time

In Massachusetts, the entire workers’ compensation process starts when an injured worker gives notice to his or her employer of an injury. If you do not tell your employer about the injury, then the employer is under no obligation to start the claims process. The employer is required by law to report an injury to their workers’ compensation insurance carrier if a work injury prevents an employee from earning their full wages for five or more days.

You should report your injury to your employer as soon as you can after the injury. Do not assume that the employer knows about your injury. If possible, you may want to give your employer notice of the injury in writing.

  1. The employer disputes the claim

Your employer may choose to dispute your injury claim. There are a variety of reasons that this may occur, but the most common reason is that they do not believe that your work actually caused the injury. They may try to argue that your injury was caused by some outside factor, which decreases employer liability.

In these situations, it can be difficult to get your claim started. However, you can report your injury directly to your employer’s insurance company in these situations. Your employer should have a notice posted that indicates how to contact the insurance company, and you can use this information to your advantage. The insurance company may want to do an investigation, but notifying them will at least get the process started.

  1. You only report the injury to your doctor

Many employees simply head to their regular doctor after they are injured at work. They may tell their doctor about their work injury, but they do not tell the employer or its insurance company about the injury. Failing to report the injury to the right people can undermine your claim.

Take the time to go through the traditional workers’ compensation process, and that will increase your likelihood of having an approved claim. If your doctor suggests a surgery or other serious procedure, and then you report the injury, the insurance company will be very suspicious about your injury and may deny your claim altogether.

Getting Legal Help

Some employers or their insurance companies will simply deny virtually all workers’ compensation claims immediately. They assume that if the employee is serious about their claim, then they will fight the denial. This process is extremely frustrating, but do not give up. Contact Jim Glaser Law today at 781-689-2277 or fill out our online form to request a free case evaluation.