Why Was My Workers Compensation Claim Denied?

Why Was My Workers Compensation Claim Denied?

You may be devastated to find out that your claim for worker’s compensation has been denied. You and your family now may be even more financially impacted because of mounting medical bills . Unfortunately, it happens–many claims, including valid claims–are denied for numerous reasons.

However, you still have legal options after your claim is denied. In most cases, you should hire a lawyer at the start when you begin to file. Having a lawyer’s assistance will reduce your chances of being denied by the insurance company in the beginning. Check out these details on common reasons for refusals and further steps for you to pursue legal action.

4 Common Reasons Your Claim May Be Denied

There are many reasons that your claim may be denied, here are four common reasons people usually don’t get their claims:

  1. There were no witnesses to your accident at work. Usually insurance companies will use this information to claim that you are lying about the accident occurring.
  2. Your injury sustained is similar to or the same as a pre-existing condition. An insurance company may claim that you sustained the injury in the past and that it is just flaring up.
  3. You missed the deadline to file.
  4. You did not pursue medical treatment or did not follow care instructions properly. An insurance company can say that your injury isn’t as serious as your claim because you failed to follow through seeking help, or that the worsening of the injury is your fault.

Filing For an Appeal

When your worker’s compensation claim is denied, then you should be provided information about an appeals process. The deadline could be a short window of time, so be sure to file before the date comes up.

If your reason for denial is easy to fix, like typos on paperwork, then you may be able to fix it with the proper information with the help of an attorney. Then you have a better chance at an appeal. You may also have to go to an administrative hearing where you will need to support your claim with supplemental evidence. You may be required to provide medical records and/or a testimony from a medical expert. An attorney will be able to gather the evidence for you and may have a contact that is a medical expert who can speak on your injuries suffered.

How a Worker’s Compensation Attorney Can Help

If your claim was denied for worker’s compensation, there is still hope! An attorney who has handled worker’s compensation such as the workers compensation lawyers Nassau County locals trust cases before can give you a consultation for free and help you decide how to best prepare for your appeal. It is highly recommended that you hire a lawyer from the very start to help you handle your affairs to offer you the best chance at receiving compensation for your injuries.


Polsky, Shouldice & Rosen, P.C.Thanks to authors at Polsky, Shouldice, & Rosen P.C. for their insight into Workers Compensation.