Common Reasons For Being Denied A Worker’s Compensation Claim

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If you injured yourself while at work, you’re probably hoping your company’s insurance will approve your worker’s compensation claim to supplement your income and pay for any medical bills.

However, insurance companies frequently deny worker’s compensation claims for a variety of common reasons. If you learn those reasons and work with a personal injury attorney before submitting your claim, you’ll increase your chances of having your claim approved.

What Are Some Common Reasons Insurance Companies Deny A Worker’s Compensation Claim?

Worker’s compensation claims frequently get denied for many reasons that you can altogether avoid.

Some common reasons insurance companies deny a worker’s compensation claim are:

  • Failing to submit your worker’s compensation claim or failing to report your injury directly to your employer before your state’s deadline;
  • Disputes over if your injury or illness occurred at work or not;
  • You filed your claim after leaving your job;
  • Your injury doesn’t meet the state standard to receive worker’s compensation benefits.

In North Carolina, employees have two years from the date the injury occurred or was reasonably discovered to file a worker’s compensation claim. If you fail to file the claim after the two-year mark, your claim will be denied, regardless of if you would have been previously entitled to benefits. You can avoid this common denial by swiftly working to gather evidence, contacting a lawyer, and filing your claim.

When a worker files a claim, the company may try to say that you weren’t working at the time of the injury, that your misconduct caused the injury, or that your current injury or ailment is not the result of a workplace accident or exposure. To prove them wrong, you’ll need to gather evidence to support your claim. Strong evidence ranges from eye-witness accounts or medical records.

Insurance companies usually deny claims when the worker has been fired, laid off, or quit from the employer they are filing against. However, if you reported the injury while you were employed or were injured in the period after you gave notice or were notified you’d be let go, your claim may still stand.

Finally, North Carolina guidelines set specific conditions that worker’s compensation claims cover. The State may enforce special restrictions for conditions such as cumulative trauma or psychological conditions, or any illnesses caused by prolonged term-emotional stress may be denied. Your injury may also need to meet a severity threshold for worker’s compensation to kick in.

What Should My Next Steps Be If I Was Injured At Work?

If you suffered an injury at work and need to file a worker’s compensation claim to help prevent getting denied, contact an experienced personal injury attorney right away. Hyland, Padilla, & Fowler’s legal team has years of experience working for North Carolina workers and winning them the worker’s compensation sum they deserve.

Our legal team can help you fill the form correctly to avoid denial, negotiate with insurance companies on your behalf, gather evidence, and advise you on the best next steps for your case.

To ensure all our clients are happy, we offer a free upfront consultation for you to understand our services better and for us to help you understand the merits of your case better.

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