What Are The Reasons For Workers Compensation Claim Denial

The worker’s compensation system helps employees to get compensation for their injuries during work. Unfortunately, the insurance company sometimes denies the claims. If you get a letter about the rejection of your compensation claim, then knowing the reasons can help you to apply another time for your claim. You can also hire a workers’ compensation attorney to get help in this matter.

The Injury Did Not Happen In The Workplace

It would help if you had the injury at work to get your claim approved. As an example, if you work in any pharmacy shop and you get injured when carrying medicine upstairs, you are likely to get compensation. But if you are on a lunch break, you may not get the compensation.

Even when you were not at the job site but at any office event or work assignment, you may get the claim approved. The insurance company and your employer may work hard to prove that you are not at work during the accident.

If you don’t have witness or CCTV footage, the workers’ compensation attorney can work for you to get you the compensation.

You Notified Your Employer After The Required Time

As soon as you get the injury, it would help if you immediately inform your employer. If you don’t notify within the required time, a lot of things may happen, such as:

  • The employer may investigate the accident necessary for the claim.
  • The employer and insurance company may argue that you were not hurt during the work; if you were, you could inform your employer.

So, if you get injured during work, inform the employer as soon as possible. Otherwise, you may not get benefits by claiming your injury compensation.


Condition Doesn’t Meet State Guidelines

Some states also apply rules and consideration for worker’s compensation due to cumulative trauma or other psychological conditions. Some states do not include the payment for illness caused by long-term emotional stress at the workplace. Even if your injury is not so severe, then your claim may not get approved. So, it would be better to take help from a personal injury attorney.

Medical Care

After the injury, you must see a specific doctor or medical care. As you are injured, you might not be able to walk a long way to see a doctor. So, you have to check up on the first round of your medical care from any nearby medical team

One of the most common causes of denial is to see an own chosen doctor, especially from the insurance company’s network. Rather see your preferred doctor after having initial treatment from the doctor from your workplace where you got the injury.

Making Delay In Paperwork

Clerical errors can also significantly contribute to denying workers’ compensation claims. The insurance company will seek a chance to reject your claim, so you should not delay in paperwork or do everything within the deadline. Even if you miss one day to fill in for your problems, the insurance company will block your claim because of missing the date by one year.

Discrepancies In Report

The insurance company will review all the documents for the same injury. They will likely deny your claim if there are discrepancies between the report ky you mm mm and your medical record. Hiring a legal professional can mitigate your claim by applying the legal terms correctly.


You Filed The Claim After Leaving The Job

If the employee files the claim after quitting the job or when the employee got fired from the workplace. However, if you report the file when you are still at the job, or you are within the notice period, then the reason may not work. Some states also apply rules for workers’ compensation files after leaving the job. In that case, hiring a personal injury attorney will be the best idea to solve this issue.


If your compensation claim gets rejected, don’t give up hope. First, see the reason why the court has denied your claim. If you know the issue is related to the paperwork and nothing else, you can request a review from the claim adjuster.

But this route is quite difficult until your employer admits their fault. So, it is always better to consult a car accident attorney to solve these issues. An experienced law professional can proceed with enough evidence to make the case strong.

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