Workers’ Comp Claim Denied by Your Employer?
You’ve been injured at work. Maybe you slipped and fell or were exposed to hazardous materials. Maybe repetitive movements caused a stress injury, or maybe a coworker dropped a heavy box on your foot. Whatever the case, you now need workers’ compensation to cover your medical bills and lost wages.
You do everything you think you’re supposed to do: you notify your employer, and you start your workers’ comp claim. But then, the unthinkable happens: you find out your employer is denying your claim! How could this be?
Today, we’re discussing when employers deny workers’ compensation claims—including why this happens and what to do about it. Keep reading to find out what you need to know!
Why Employers Deny Workers’ Compensation Claims
The simple fact of the matter is that employers hope to pay out as little as possible for workers’ compensation claims. Why is that? Think of what happens when you put in a claim with your auto or home insurance company: your premium goes up. Similarly, the more workers’ comp claims are filed, the more an employer might have to pay. As a result, employers are incentivized to pay for workers’ comp only when they have to!
Workers’ compensation claims can be denied because of employer bias or even because of employer dishonesty.
When Your Employer Is Biased
Some employers can be very suspicious of even legitimate workers’ compensation claims. They might make it a point to investigate claims because they are mistrustful of their employees or because they have experienced workers’ comp fraud in the past.
In this case, your employer might argue one of the following reasons for denying your claim:
- Your injury wasn’t serious
- You didn’t get injured at work (or in the course of performing your job duties)
- Your injury doesn’t require medical care
- You don’t require time off for your injury
This often happens in certain kinds of cases.
One example is when an employee suffers a repetitive stress injury, like carpal tunnel or a back injury. In this case, it’s often hard to prove where and how the employee got the injury. Did repetitive movements at work really cause your carpal tunnel, or was it something else? The employer might argue the latter and deny the claim.
Another example is in cases where the injury isn’t easily verifiable, like chronic pain. Sometimes, legitimate medical conditions are hard to diagnose or verify—but that doesn’t mean the employee is lying. However, the employer might not believe the employee, resulting in a workers’ comp denial.
When Your Employer Is Dishonest
Sometimes, honest mistakes happen when filing workers’ compensation paperwork. In other cases, however, employers are outright dishonest in order to avoid paying for workers’ compensation. They might do things like:
- Tell you that you aren’t entitled to make a workers’ compensation claim in the first place (this is untrue)
- Fail to get (or keep) workers’ compensation insurance coverage (this is illegal)
- Refuse to file a report of your injury
- Include incorrect information on the First Report of Injury (FROI)
- Lie about the circumstances of your injury (e.g. saying the injury didn’t happen at work)
- Give wrong information about your wages or job duties
If any of the above happens, your claim can be denied thanks to employer dishonesty.
What to Do after a Workers’ Comp Denial
If your workers’ compensation claim has been denied, don’t despair! You have options.
You can appeal the denial yourself, or you can fight for your workers’ compensation benefits with the help of a skilled workers’ comp attorney.
Hiring an attorney can be very beneficial. A qualified attorney will work to gather all of the medical and other evidence needed, depose medical experts, communicate with insurance companies, represent you at your workers’ comp hearing, and negotiate a favorable settlement.
What’s more, having an attorney means that you can increase your odds of success while you focus on getting better. Let someone else handle your complicated workers’ comp claim: you have enough to deal with!
Contact Us Today
When you’ve been injured at work, you deserve workers’ compensation benefits. You don’t have to feel guilty about using them. They are benefits you’re entitled to receive, so you can pay your medical bills and cover your expenses while out from work. You shouldn’t have to worry about finances because of an injury or illness.
Remember that a workers’ comp denial from your employer isn’t the final answer. Call Casper & Casper today to talk to an experienced Cincinnati, OH workers’ compensation lawyer about your case.
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