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San Antonio Workers’ Comp Claim Denials

Was your claim denied? Let our attorneys help.

Under the law, every employer is required to carry workers’ compensation insurance to cover any damages that an employee may suffer while executing his or her responsibilities. The reality is that employers and the provider that they hire do not have the employee’s best interests in mind. Their interests are for their own legal standing and finances, not yours.

At The Law Offices of George P. Escobedo & Associates, PLLC, our San Antonio workers’ compensation lawyers have more than 10 years of experience and are dedicated to advocating for workers in our community who need and deserve financial support. Your claim does not have to end at a denial, and we know what it takes to fight for you.

Common Reasons for Claim Denials

Perhaps more frustrating than suffering an injury at your workplace, is being denied for coverage under your employer’s workers’ compensation insurance. If you have sustained an injury while on the job, it is your right to receive financial support to cover the costs of your medical bills and the loss of wages that may result. Unfortunately, our San Antonio workers’ compensation attorneys know that these rights are not always upheld.

Reasons that your claim may be denied include:

  • The claim was not filed or reported within the statutory time period
  • Your employer was not promptly notified
  • The claim was filed after you were fired or laid off
  • The injury was not witnessed
  • Your employer does not believe the injury occurred while on the job
  • A discrepancy is found between report and medical records
  • The injury occurred while you were under the influence of alcohol or drugs
  • Your illness or injury is not covered or is not believed to be serious enough for coverage

While some of these reasons can be backed by documentation and evidence, others are based solely on disputes about the legitimacy of injuries and their causes. The best way to fight a claim denial is to avoid one altogether, which requires gathering all relevant information that can prove your injury and the causes. Additionally, it is essential to file the claim immediately and report your injury to your coworkers and supervisors, keeping your story as detailed and consistent as possible.


If your claim was denied, we can discuss your options in a free case evaluation.


What can I do next?

Most claim denials are eligible for appeals within a certain period. If you plan on appealing, you must do so within the deadlines, or you will not be able to receive the compensation you deserve. The appeal process can be a very complicated and stressful procedure, so your best chance is to have an experienced and knowledgeable attorney guide you through the legal processes.

Appeals might not be your only option. In some cases, you may be eligible to re-open a claim that has been closed. However, each case is unique and the grounds for re-opening your case may be confusing or require an attorney to discover in the first place.

Claims can be re-opened in the following scenarios:

  • Your injury or illness has resurfaced or worsened
  • The functional alternatives or accommodations no longer exist
  • New evidence has surfaced that proves your injury claim
  • New evidence has surfaced that proves the initial award or decision was unjust
  • A legal or administrative error was found in the initial process
  • Fraudulent actions of the employer or provider are discovered

We’re Ready to Help

Whether you have not yet filed your claim, or have received a claim denial, The Law Offices of George P. Escobedo & Associates, PLLC is ready to advocate for you. We can help you ensure that your claim is filed in a manner that gives you the best chance of avoiding a denial, or can discuss your options for appealing or reopening your case. Our team of workers' compensation attorneys in San Antonio is on your side every step of the way.

Let’s get to work. Give us a call to get started today!