Why Can a WC Claim Get Denied?
Some workers’ compensation claims get denied because the employee did not notify the employer of the injury soon enough or because the insurer doubts that the injury is work-related.
If you have ever filed an insurance claim after a car accident, even if you were not injured and were only claiming expenses related to vehicle repairs, it is probably obvious to you that the top priority for insurance companies is to make money, not to compensate claimants adequately for their financial losses. Unfortunately, this is also true in the case of workers’ compensation insurance claims. It should be easy to get your medical treatment paid for, and to receive the applicable benefits if the injury renders you temporarily or permanently unable to perform your work duties, but too often, it is not. Workers’ comp insurance companies will look for any excuse to pay you less money; they will count it against you if you make any mistakes with your claim, and sometimes even if you do everything right. An Omaha workers’ compensation lawyer can advocate for you so that you can get the money and treatment you need.
Common Reasons for the Denial of Workers’ Compensation Claims
These are some common reasons that employers and their insurance companies deny workers’ compensation claims:
- The employer denies that the injury did not occur in the course and scope of your work.
- The employee waited too long before reporting the injury to the employer.
- The employer alleges that the employee was under the influence of alcohol or drugs at the time of the work accident.
- The employer sought treatment from a physician who is not covered under the employer’s workers’ compensation insurance policy.
- The employee did not seek treatment for his or her injuries, or the employee waited a long time before seeking treatment. In the latter case, there is room for the employer to deny that the injury occurred at work.
- The employee missed one or more deadlines for filing documents related to the workers’ compensation claim.
- The injury occurred because employees were playing practical jokes, roughhousing, or otherwise behaving recklessly at work.
- The insurer alleges that the employee’s symptoms are due to a pre-existing medical condition and are not the result of the work accident.
These are only the fair reasons that workers’ compensation insurance companies deny employees’ claims. Your employer might persuade the insurance company to deny your claim simply because your employer does not want to pay. If you hire a workers’ compensation lawyer, the chances are much better that you can successfully appeal a denial of your claim, as well as the chances of getting your claim accepted on the first try.
Contact Andres Law Offices, PC LLO About Avoiding Unfair Denials of Workers’ Compensation Claims in Omaha
An Omaha workers’ compensation lawyer can help you be meticulous with your workers’ compensation claim so that the insurer does not deny your claim on a technicality. Contact Andres Law Offices, PC LLO in Omaha, Nebraska about your case.