Law Office of Howard J. Stevens APC
Over 40 Years Of Experience In Workers’ Compensation

Why are people denied workers’ compensation? 4 causes

On Behalf of | Nov 21, 2023 | Filing/Appealing A Claim

A workplace injury could jeopardize a worker’s employment. Injured workers may be eligible for workers’ compensation benefits, which could help them earn lost wages and pay for medical bills.

Unfortunately, many workers don’t get the compensation they need because of a denial. Here’s how that happens:

1. The injury didn’t happen on the job

Workers’ compensation is only eligible to workers who are injured while on the job. A worker who is driving to work and suffered a car accident would likely not be eligible for workers’ comp. However, If the worker was in an accident while driving for their job, their injuries may make them eligible for workers’ comp benefits.

2. The injury was never reported

An injured worker must report an accident to their employer or manager in a timely fashion. Injured employees have 30 days from the day of the injury to report it –  and one year to file a claim. Workers who do not meet the statute of limitations may not be eligible for workers’ comp.

3. The injury was not examined

Injured workers typically have to have a medical examination before they receive any medical benefits. Some employers require that injured employees seek medical professionals who are certified for workers’ comp injuries. 

4. An injury was caused through horseplay

Workers’ compensation is a no-fault system, which means an accident could be caused by an employer, co-worker or employee and the injured worker would likely still be eligible for benefits. But, if a worker was fooling around and engaged in “horseplay” that put them in danger, they may not be eligible. 

Injured workers who understand their legal rights often have a better time getting workers’ compensation benefits. Unfair denials are common, and appeals are often successful.