If you are getting ready to hire an attorney and file a case with your employer's worker's compensation insurance carrier because you were injured on the job, then it is important that you watch out for these four common reasons worker's compensation cases are denied:
Denial Reason#1: The Insurance Company Claims Your Injury Didn't Happen During the Course of Your Workday
In order to be able to file a claim against your employer's worker's compensation insurance, your injury must happen during the course of your workday. For instance, if your employer sends you to the bank to make their deposit and you get in an accident along the way, then you are considered to be working and are covered. However, if you are on your way home from work, then you are not covered because you are no longer actively working.
Denial Reason #2: Your Employer Isn't Responsible for Your Injury
Even if you were injured at work, your employer is not necessarily responsible for the injury. For example, if you have bad knees from too much running and your knee goes out at work, then this is a pre-existing medical condition and does not qualify as a worker's compensation injury. However, if you have bad hips and someone leaves a puddle of cleaning solution on the floor and you slip and fall in it, then your injuries are considered to be work-related.
Denial Reason #3: Your Case Appears to Lack Credibility
When an insurance company's adjuster is looking at your case, they will be more likely to not settle with you if your case appears to lack credibility. For example, if you have not completed all of the necessary forms or if you claim you were seriously injured but you never bothered to visit a doctor. To ensure your case is credible, you should consult with a local worker's compensation attorney and ask them to assist you with the necessary paperwork for your case.
Denial Reason #4: Your Doctor Doesn't Appear to be Credible or Has a Bad Reputation
Finally, your case could be denied if your doctor doesn't appear to be credible or has a negative reputation in the community. For example, you should not visit a doctor who is known in the community for being easy to get pain medication from or who has been sued in the past. Just as you need to hire a lawyer to fight for you, like Oxner + Permar, LLC, so too do you need a high-quality doctor on your side as well.