Why Was My Workers’ Compensation Claim Denied?

Your employer has an obligation to provide a safe work environment to ensure no employee is injured while performing his or her duties. Unfortunately, some employers fail to do so and, as a result, injuries happen. If you were injured on the job and pursued a workers’ compensation claim that was denied, you do not have to accept this as the final word on this matter. The workers’ compensation process can be quite complex, however, so you will need an attorney on your side to appeal this decision to increase your chances of successfully receiving the benefits you deserve.

Here are some the reasons why your workers’ compensation claim might have been denied:

  • Your injury did not occur at work: In order to be eligible for workers’ compensation benefits, you must have sustained your injury while performing job duties. If you work at a restaurant and twisted your knee while taking dishes to the kitchen, you will likely be able to obtain these benefits. If you injured yourself while on your lunch break, or during your commute to the restaurant, however, you will likely be unable to make a valid claim. That said, this is not a totally black and white situation. If you were not at your job site, but at a work assignment or event, you might have a claim. Keep in mind that insurance companies and your employer will work hard to prove you were not at work when your injury occurred, even if you know you were, so you might have to fight back. This is why it is critical to have a skilled attorney on your side.
  • You failed to notify your employer about your injury: Once you are injured on the job, you need to inform your employer of it as soon as possible. In fact, you have a limited timeframe to do so, so make this a priority. Failing to report it will mean that your employer cannot conduct an accident investigation, which is an important element for the success of a claim.
  • You were intoxicated or under the influence of drugs: If alcohol or drugs were involved in your accident, you will not be entitled to a workers’ compensation claim. If tests show that you were under the influence at the time of your injury, your claim will likely be denied.
  • You did not receive treatment from an approved medical provider: Your boss and the insurance company both have the right to provide you with an approved list of doctors from which you can seek treatment. In many cases, this can be negative because they might try to downplay your injuries, leading to lower benefits. This is another critical reason why you should hire a workers’ compensation attorney. He or she will help you navigate this process and help ensure you are not being taken advantage of.
  • You did not seek medical treatment: If you do not seek medical treatment after sustaining an injury at work and later try to file a claim that is not supported by medical records, the insurance company will argue that you faked the injury to obtain benefits. Protect your health and your chances of obtaining compensation by visiting a doctor as soon as possible.
  • Your employer disputes your claim: One of the main reasons why a claim might be denied is simply because your employer disputes it. This is often done out of fear that their workers’ compensation coverage will increase. If there is no surveillance footage or no witnesses to support your claim, you can bet your employer might try to argue the details of the case or even claim that you were not at work when you sustained the injury.

Having a skilled attorney on your side from the get-go can greatly increase your chances of receiving the benefits you need without having to go through the process of an appeal. However, if your claim was denied, it is not too late. Get the help that you need now.

Workers’ Compensation Attorneys in Santa Ana

If you were denied workers’ compensation benefits after sustaining an injury while on the job, you do not have to accept this outcome. At Ufkes & Bright, our experienced team of workers’ compensation attorneys in Santa Ana will offer prepared, proven guidance as we assist you in navigating the process, no matter what stage of the process you are in. Reach out to us today.

Call our office at (714) 909-2609 to get started on your case and request your free consultation. You do not have to go through this process on your own.

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