Reasons why your Compensation Claim is Denied

Reasons why your Compensation Claim is Denied

Reasons why your Workers' Compensation Claim is Denied

Workers' compensation or workers' comp is a form of insurance rather than a product of an injury claim, serving as a and providing "wage replacement" and medical assistance to injured employees where they have sustained it in the course of their job or within the vicinity of work place, it is an exchange for renoucing plaintiff's right to sue their employer from their notion of negligence or deliberate deriliction of duty that put their employee in danger. Mainly, employees reason to file a workers' compensation is to get your financial and health status get covered from damage they have sustained in the course of their work, reason ranging from negligence to accidents. 

Oftentimes, employers' insurance company denies one's claim rendering them to hire an injury lawyer to work with them for a formal litigation of the case. These are the reason why insurance companies tend to deny your claim, some of them are: 

  1. Sustenance of injury was not reported immediately
    Insurers like in the field of workers' compensation are not fondly highly of delay report of an accident or sustenance of injury, they even likely to ignore it when filing it alone without help from an attorney. Since lawyers are meticulous about details, they base on workers' compensation policy that it should be reported in shourt notice maximum of seven days, because they will likely to think that if you report it really late, they'd assume that you aren't hurt and only file a claim on a whim or for the compensation pay. 

  2. Discovery of Unwitnessed Injury
    Insurers from any variety doesn't likely to agree with unwitnessed injuries. As previously mentioned, they are highly attentive to details and more even if the vast majority of unwitnessed accidents, they probe scenarios such as that. If one is hurt at work due to apparent negligence, it is recommended to tell everyone the manner how it happened and every details they have to know and make sure that your story aligns to your injuries, though that is the least you can do about it since insurance companies tend to ignore that and you have nothing to do about it. Still, file a claim and work with an injury lawyer since it is free as they are paid when you are paid as well, nothing to lose but you can gain from such action.

  3. Inconsistency to Statements about Injuries and Recent Medical Records 
    Inconsistency of an employee's statement about his injuries as well as his recent medical records, even if at other matter, would make authorities and insurance companies skeptical about believing one's statement as if they were lured into something. It would definitely threaten the chances of your claim if you tell medical professionals and your employer two whole different story or even one discrepancy in your story of sustenance an injury. As stated above, completely tell everyone involved in the job and your doctor the same story and pinpoint important details so it would benefit your claim as insurance company's attorney would investigate both sides and give off similar story.

    And, if they found out an employee's recent medical records that he is/was under influence of drug or has history about it, insurers immediately be decisive about not granting an employee his/her workers' compensation pay. 

  4. Filing a claim after being fired 
    Insurance companies never give favor to an employee's claim being filed after legitimately fired, they think of the claim as a mere revenge claim or a safety net as they don't have enough money for the next hiring. Even if we say this employee has been injured in his times as an employee in the company or business, insurance companies get off their attention over claims from an ex-employee. In the previously mentioned point in this blog, they even barely like delayed filing of an injury claim, what more of a claim filed after getting laid off by their employer. This would serve as lesson for those tardy employees that filing a claim should be switf, and even more swift with a help from a legal professional such as an injury attorney where they legally present your case, investigate about it, gather your edges and help you exercise and protect your rights as an victim of negligence and resulted into sustenance of an injury.

The attorneys at Ryan, LLP have built their reputation representing individuals and small businesses against large insurance corporations, government agencies, and financial institutions. The firm handles cases including personal injury, wrongful death, catastrophic injury, medical malpractice, insurance bad faith, and business torts. Ryan, LLP serves clients throughout the State of Ohio, primarily in the Cleveland area.

Get the Justice You Deserve with our experienced & Free Legal Consultation