What Causes a Workers’ Compensation Claim to Be Denied?

In a perfect scenario, the process of filing a workers’ compensation claim would be straightforward, and all legitimate claims would be approved. However, this is not always the case. There are instances where these claims are denied, often leaving workers frustrated and confused. Here are three common reasons why a workers’ compensation claim might be denied.

Improper Filing of the Claim

One prevalent cause of denial is improper filing of the claim. There are strict rules and timelines to adhere to when filing a workers’ compensation claim. Failing to notify your employer of the injury within the specified timeframe, incorrect or incomplete information on the claim form, or not providing sufficient medical evidence to support the claim can all result in the denial of your claim.

Lack of Causation

A denied claim could be due to a lack of causation. For a claim to be successful, there must be a clear connection between the injury or illness and the worker’s job duties or work environment. If it is deemed that the injury occurred outside the workplace or as a result of non-work related activities, the claim can be denied.

Pre-Existing Conditions

Sometimes, pre-existing conditions can complicate a workers’ compensation claim. If an employer or insurer can argue that the injury or illness was not work-related but rather a flare-up of a pre-existing condition, your claim may be denied.

In conclusion, understanding the potential pitfalls that could lead to a denied claim is critical for those seeking workers’ compensation. Ensure proper filing, demonstrate clear causation, and be upfront about any pre-existing conditions to increase the success of your claim.

At The Gatti Law Firm, we work to help people through the complex problems that often arise in workers’ comp claims. It’s our goal to help you understand your rights and pursue the benefits you deserve when you need them most. We’ll be there for you every step of the way.

Call us at (503) 543-1114 and learn how we can be there for you!

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