Why Are Workers' Compensation Claims Denied?

In many workers' compensation cases, employees who have suffered serious injuries are shocked to discover that their claim was denied. While you can appeal these decisions, it is crucial to do so with the help of an experienced Oklahoma workers' comp attorney who can help you identify why the insurance company rejected your claim. In this blog, we explore some of the most common reason for workers' comp denial.

You Didn't Report Your Injury In a Timely Fashion

Many injuries suffered in the workplace do not seem severe at first, yet turn out to be serious medical conditions. For example, your wrist may hurt after falling off a ladder, but you may not realize that it is fractured until several days later, when it continues to get worse. Due to the expensive cost of medical care, it is understandable that employees are often hesitant to seek treatment.

However, insurance companies will see this, and will question whether your injuries were actually work-related, or if they are really that serious. In these cases, you need a skilled legal advocate who can gather evidence, and build a strong case for your appeal.

Your Medical Records Don't Match Your Report

The insurance company will question your claim if your reported injuries don't match your medical records. It is important to be consistent when telling the story of your injury, as any discrepancies will be major red flags for the insurance provider.

You Had Illicit Drugs In Your System

If your accident sent you to the emergency room, and those medical record found illicit drugs in your system, the insurance provider will almost always deny your claim. While a skilled attorney may be able to appeal, it can be very challenging in these cases.

Your Claim Was Filed After Being Fired

Not reporting your injuries in a timely manner is already a red flag for insurance companies, but if you are fired or laid off before filing a report, your claim may look extra suspicious. Insurers typically assume that these claims are filed for revenge against a former employer, even when the claim seems valid.

If you have been injured in the workplace, our attorneys can help you pursue the benefits you need and deserve. Call (888) 842-1374 to get started with a free case evaluation.

Categories: Workers' Compensation

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