Top Reasons Workers’ Compensation Claims Are Denied

Has your workers’ compensation claim been denied?

The workers’ compensation system is designed to provide benefits to employees who get injured in the course and scope of their employment. However, there have been cases when the employer has denied a claim and the injured worker has to hire a Missouri workers’ compensation attorney to receive the benefits.

The Injured Worker Failed to Report the Injury in Time

It is important that you notify your employer and document everything as soon as possible. The more you delay it, the more you will find it difficult to prove the injury. The insurance company may contend that because you never reported the injury, it never occurred.

There Is No Witness to the Injury

If no one witnesses your injury, then you may find it hard to prove that the injury was indeed work-related. You can avoid this situation by reporting the injury immediately to your supervisor or employer.

Accident Report and Independent Medical Exam Are Inconsistent

Once you report the injury to your employer and complete an accident report form, your employer may order an independent medical exam. If your claims are found inconsistent with what the doctor has found in the medical exam, the insurance company will have a solid reason to refuse the claim. Provide all details correctly when you make an injury report and when you are giving a statement to your employer.

The Claim Was Filed After the Worker Was Laid Off or Fired

In some cases, the injured worker fails to file the claim in time, and before the claim is filed, the injured worker gets fired or laid off. In such a situation, when the injured worker files the claim, the ex-employer may think of it as a revenge claim and deny it. So, it is extremely important that you report the injury immediately.

The Worker Was Found Intoxicated at the Time of Injury

During the medical exam, if you are found to be under the influence of drugs or alcohol at that time, your insurance company will have a reason to deny the claim.

The Worker Refused to Give a Recorded Statement to the Insurer

The insurance company may request a recorded statement from the injured worker, but without the help of an experienced Missouri workers’ compensation lawyer, the person may not be comfortable giving the statement. Once the injured worker refuses to give the statement, the insurer will have a reason to deny the claim.