A workers’ comp claim is approved based on several things. The insurance company will look at the details of your accident, your job duties, and how the injury occurred to determine whether you are eligible for benefits. While the process can be complicated, understanding the top five barriers to getting your workers’ comp claim approved can help make the process a little easier.
5 Barriers To Getting Your Workers’ Comp Claim Approved
The Workers’ Compensation system is designed to help injured employees on the job, but the process is not always straightforward. In some cases, claims are denied for valid reasons, but there are also times when claims are denied unfairly.
The National Council on Compensation Insurance says 11.1% of workers’ compensation claims were turned down in 2016.
Here are five of the most common reasons why claims are denied :
1. Your employer may not have a workers’ compensation insurance.
Your boss might not have insurance for workers’ compensation. It means that if you get hurt on the job, you might not be able to attain these benefits.
Before you start work, it’s essential to check with your employer to see if they have workers’ compensation insurance. You can also ask the workers’ compensation board in your state.
Workers’ compensation boards at the state level can also help you with your benefits.
2. Your injury might not be related to your job.
What if your injury isn’t considered work-related?
There are a few situations where your injury may not be considered work-related :
- If you were injured during your commute to or from work
- If you were injured while you were on a break
- If you were injured while you were off work
In these cases, you may still be able to get workers’ compensation if your employer was negligent in some way. For example, if your employer didn’t provide safe transportation to and from work.
3. You might not have told your boss about your work injury.
Depending on your state, the required time frame may be as short as 24 hours or as long as 30 days. If you don’t tell your boss about your injury on time, you might lose your right to workers’ compensation.
You have . The reporting time frame starts from the injury or the date you realized your job caused the injury.
You should report the injury as soon as possible to ensure you get the medical treatment and wage replacement benefits you’re entitled to. Your claim might be denied if you don’t tell your supervisor about the injury soon enough.
Not everything has to be reported immediately. Suppose you cannot report your injury immediately due to medical treatment or hospitalization. In that case, you will still be eligible for benefits if you report your injury as soon as possible.
4. You may have returned to work before your injury has healed.
If you return to work before your injury has healed, you may find that your workers’ compensation claim is denied. The insurance company could say that your injury wasn’t as bad as you said it was, which means you don’t deserve benefits.
It’s essential to keep in mind that you shouldn’t rejoin until your doctor says it’s okay. If you do return to work before you are fully healed, you may find that your workers’ compensation claim is denied.
5. You may have already received workers’ comp benefits for a previous injury.
You may have already received workers’ comp benefits for a previous injury. If so, you may question if you can get new work-injury benefits. The answer is maybe.
You may be eligible for benefits if you have a new injury related to your old injury. For example, if you injured your shoulder in a car accident and then re-injured it playing basketball, you may be able to receive benefits for the new injury.
However, if your new injury is not related to your old injury, you will not be eligible for benefits.
How to Overcome These Barriers?
If you have been injured at work and your workers’ comp claim has been denied, you may feel like you have nowhere to turn. A workers’ comp attorney can help you receive your compensation claims benefits.
Your workers’ comp lawyer will review your case and help you find the proof you need to back up your claim. They will also represent you in appeals and hearings and negotiate with the insurance company on your behalf.
Getting help from a workers’ comp lawyer will give you the best chance of getting the benefits you need to cover your medical expenses and lost wages.