Workers’ compensation is insurance that benefits employees who suffer work-related injuries or illnesses. However, even though the workers’ compensation system is designed to support injured workers, there are some situations where a workers’ compensation claim may be denied.
Here are some of the most common reasons a workers’ compensation claim may be denied. Knowing what these are can help you avoid this situation.
1. Failure to report the injury promptly
One of the most common reasons workers’ compensation claims are denied is a delay in reporting the injury. You must report your injury to your employer within 30 days in California, but reporting it sooner (almost immediately) is better. Failing to report the injury promptly may give the employer and insurance company the impression that the injury did not happen at work or is not severe.
2. The injury did not happen on the job
The injury must have occurred during your employment for a workers’ compensation claim to be approved. If you were injured while doing something outside the scope of your work duties or outside of work hours, your claim might be denied.
3. There were no witnesses
Another reason why workers’ compensation claims are denied is a lack of witnesses. If no one saw the accident, the employer or insurance company may argue that the injury did not occur at work.
4. Failure to seek medical treatment
Your claim may be denied if you fail to seek medical treatment for your injury or delay seeking medical attention. The employer and insurance company may assume that the injury is not severe or work-related if medical attention is not required immediately.
While workers’ compensation is designed to support employees who suffer work-related injuries, it is not always guaranteed that your claim will be approved. If your claim is denied, do not give up. You have legal options to get the benefits you deserve.