For an on-the-job injury, you usually expect your employer to step in and offer compensation for the resulting medical treatment, lost wages and other miscellaneous expenses. However, your employer may decide to deny your worker's compensation claim. The following offers a few reasons why you may not be able to receive the compensation you deserve.
You Didn't File Your Claim In Time
Most claims for worker's compensation are time-limited, meaning that you only have a brief amount of time to report your injuries and file your claim before it surpasses the statute of limitations established by your state. For example, many states require that you report your on-the-job injury to your employer within a 30-day period. Other states require that all injuries be reported as soon as they occur.
After reporting your injury, you'll usually have a 30- to 90-day window in which to file your worker's compensation claim. Keep in mind that some states may offer a much longer window depending on the circumstances involved. There are also several instances where you're given more time to prepare and submit your claim:
- You're in a coma or have suffered another type of injury where you're unable to file a claim on your own
- You're undergoing immediate and lengthy treatment for a serious, life-threatening injury
- You're under quarantine for an easily communicable disease or illness
Your State Doesn't Allow Your Claim
Each state has its own rules and regulations concerning worker's compensation claims. For instance, certain injuries may not be eligible for worker's compensation under your state's statutes. These may include non-physical injuries such as stress-related injuries or emotional distress. It's important to consult with your worker's compensation attorney to make sure that your injuries meet the criteria established in your state's worker's compensation rules and regulations.
Even if your claim is invalid according to your state's statutes, you may be able to proceed with other legal action. As an example, you can file a personal injury lawsuit to recover damages for any stress-related injuries you've suffered while on the job.
Your Employer Successfully Disputes the Claim
Another reason why your worker's compensation claim could be denied is that your employer managed to successfully dispute the claim. Your employer could argue against your claim by using the following arguments:
- Your current injury occurred off the job
- Your current injury wasn't directly caused by the accident that happened on the job
- Your injuries are pre-existing and therefore not eligible for worker's compensation
- Your claim is invalid due to the other points mentioned above (time limits and state statute limitations)
To lower your chances of your employer successfully disputing your claim, you'll need to have additional evidence to back up your claim. If nearby bystanders or fellow employees witnessed the accident leading up to your worker's comp claim, you can use their eyewitness accounts to bolster your claim. A doctor's statement outlining your current injuries and how they can be attributed to your on-the-job accident may also help.
Your Employer's Insurance Provider Denies the Claim
Even if your employer decides not to dispute your worker's compensation claim, your employer's insurance provider may decide to deny your claim. It's not out of the ordinary for worker's comp insurance providers to reject claims, especially if they involve expensive medical treatments for the injured worker. Insurance providers may even go as far as hire private investigators to quietly monitor the day-to-day activities of claimants in order to sniff out potential fraud.
Don't forget that you can always appeal your worker's compensation claim denial with the help of an experienced attorney. Before starting the appeals process, make sure you get in touch with your employer's insurance provider to find out the reason behind the denial and if the provider is willing to reconsider its decision. If the provider refuses to reconsider, then you and your attorney can submit a formal appeal with your state's labor board.
For more information about working through a personal injury claim, contact a firm such as Law Office of Leslie S. Shaw.