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Last Updated on March 9, 2023 by Carlos Lopez
If you’ve been injured in a work-related accident or have an illness you believe is related to your employment, you are entitled to compensation for your injuries.
However, some cases – especially those regarding repetitive injuries or illnesses related to working conditions – can more easily be disputed by an employer. This leaves you wondering: Can my employer deny my workers’ compensation claim?
Common Reasons for Denial of Workers’ Compensation Claims
There are some cases where employers or their insurance companies seek to deny a workers’ compensation claim.
It’s no secret that workers’ compensation claims are expensive and can be a hassle. This means many employers and insurance companies may look for any reason possible to deny a worker’s claim.
Some common reasons workers’ compensation claims may be denied include:
- Missed deadlines: Workers’ compensation claims have strict deadlines during which things must be filed. For example, you have a very small window of time after realizing your illness or injury may be employment-related to notify your employer, so you cannot delay telling someone. The same goes for actually filing your claim, responding to correspondence, and other deadlines set by the courts. Each state has its own rules regarding these deadlines, and if you don’t follow them, your case may be denied.
- Disputes over your condition: If you fell off a ladder at work and broke your leg, disputing whether or not your injuries are work-related is difficult. However, if you suffer from carpal tunnel disease from years of assembly-line work, or you developed a lung condition because you’ve spent years breathing in dangerous chemicals at work, these conditions are a little more difficult to directly track. Your employer may deny your claim if there isn’t an obvious link to a work-related experience, but you can appeal the denial.
- Your condition doesn’t meet state guidelines: Each state has its own requirements when it comes to the types of conditions covered under workers’ compensation claims, such as repetitive trauma or psychological conditions. If your claim was made for a condition not covered under your state’s workers’ compensation regulations, it may be denied.
- You filed after you left your job: Insurers often deny claims that were filed after an employee was laid off, fired, or quit. However, you may have a good reason for the delay in filing, such as you reported the injury while you were still employed, you were injured in the period after you gave notice you were resigning, or you were fired as the result of you reporting your injury.
What Do I Do If My Claim Was Denied?
Just because you receive a denial of your workers’ compensation claim doesn’t mean the end of the line for your case.
Begin by looking closely at the notification you received that your claim was denied. In that letter, you will be given the reason for the denial.
If you believe your claim was denied for an invalid reason, you can appeal that denial. Every state’s appeals process and deadlines are different, so pay careful attention to the regulations in your state, and get an attorney to help you if you feel the need.
Bottom Line: Your Employer Can Deny Your Workers’ Compensation Claim, But You Have Rights
Yes, your employer or your employer’s insurance company can deny your workers’ compensation claim. If there is a valid reason for that denial, then there isn’t much you can do.You should also read:Permanent Total Disability: What You Need to Know
However, if there isn’t a valid reason, you need to file a timely appeal of the decision to protect your case. An attorney can help you with this appeal, giving you the best chance of getting the compensation you deserve.
Experienced Workers’ Compensation Attorney in Washington, D.C.
When you’re injured at work, you can be met with a lot of uncertainty. Will you be able to work again? How will you pay your bills? Who’s responsible for your medical care?