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Why Do Workers’ Compensation Claims Get Denied?

If you’ve been injured on the job, you have the right to file a workers’ compensation claim and receive benefits related to your injury. Insurance companies are notorious for denying workers’ compensation claims over the slightest mistake. Making the following errors could cost you a favorable decision.

Missing Deadlines

Workers’ compensation claims have strict deadlines, and missing them will cause your claim to be denied. It’s imperative to submit the following information in a timely manner when applying for workers’ compensation benefits:

  • Injury Report
  • Workers’ Compensation Claim Application
  • Claim Appeals - if your initial workers’ compensation claim is denied, you will be provided with an appeal deadline date in your denial letter.

Missing Information

It’s crucial to include all the information required when filing a workers’ compensation claim. Ensure you supply the following pertinent documents and details that are needed relating to your injury.

  • Time, date and location of where the injury happened
  • Name of witnesses to your injury
  • What part(s) of the body the injury was sustained
  • Supporting medical documentation and records
  • Personal information such as social security number and date of birth

Insufficient Medical Documentation

One of the top reasons workers’ compensation claims get denied is due to the lack of medical evidence. It’s critical that you submit all required medical reports and documents to support your claim. Insurance companies often look for discrepancies between the injury report and medical records. Having a supportive doctor who is well-versed in workers’ compensation claims and preparing corresponding medical reports can help increase your chances of a favorable decision.

Listening to your doctor’s orders is paramount. If you refuse treatment or fail to follow your doctor’s medical advice, you could lose your rights to workers’ compensation benefits. If your doctor orders you to take time off from work, limit work duties or reduce your hours it’s important to do so. Also, know that employer retaliation for filing a workers’ compensation claim is against the law

If you’ve been denied workers’ compensation benefits or need assistance with your claim, contact The Law Offices of George P. Escobedo & Associates, PLLC at (210) 807-3178 today. Our team of skilled workers’ compensation attorneys will discuss your options so you can get the compensation that you deserve.