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Common Reasons for Workers' Compensation Claims Being Denied

May 17, 2023

Wokers Compensation

Workers' Compensation claim Workers' Compensation claim

Not all Workers' Comp claims are approved. Several are denied due to being filed outside the required deadlines, while others may be denied due to insufficient or inaccurate information being included in the file. If you know why claims are often denied, it will help you avoid making the most common mistakes that will set you up for a denial. We have listed six such reasons for claims being denied here. Let’s discuss them. 

Table of Contents:

  1. 1. The Injury Didn't Happen at Work
  2. 2. You Didn't Notify Your Employer
  3. 3. You Were Under the Influence of Drugs and Alcohol
  4. 4. You Didn't Receive Appropriate Medical Care
  5. 5. You Didn't Go to the Doctor at All
  6. 6. You Didn't Hire a Workers' Comp Attorney
  7. Get the Best Workers’ Compensation with CF&P Insurance Brokers

1. The Injury Didn't Happen at Work

If it is determined that the injury happened while you were away from your job and not performing any type of job-related task, your claim will be denied. If you travel for work and are considered to be “off the clock”, your Workers' Compensation claim can be denied, especially if the accident had anything to do with recreational activity.

2. You Didn't Notify Your Employer

If you have been injured at work or while performing a work-related task away from your place of employment, you are required to report the injury to your employer within a specific period of time. This deadline will vary from state to state. Don't wait to notify your employer of an injury. The sooner you file your claim, the more likely it is that your claim will be approved.

3. You Were Under the Influence of Drugs and Alcohol

Any time you are involved in a work-related accident, you will be required to take a drug test. If it is shown that you were under the influence of drugs and alcohol at the time of the accident, your claim will be denied and your employment may be terminated.

4. You Didn't Receive Appropriate Medical Care

If you have been injured on the job, you will need to go to a physician who is approved to provide treatment for work-related injuries. Most people choose to go to an emergency room to receive immediate care. Waiting to go to a health care practitioner who does not have the training or medical degrees needed to accurately diagnose your injuries may cause your Workers' Compensation claim to be denied.

5. You Didn't Go to the Doctor at All

If you filed a Workers' Compensation claim without going to the doctor at all, you will have no medical proof to back up your claim of an injury. If you do not go to the doctor to verify your injuries, your claim will automatically be denied. If you receive an injury, time is of the essence! Go to the doctor immediately to have all of your injuries verified.

6. You Didn't Hire a Workers' Comp Attorney

If you file a Workers' Compensation claim without having an attorney who specializes in this type of law, you may not understand the process. This may lead to your claim being denied. If you have been injured in a work-related accident, contact a Workers' Comp attorney right away.

Get the Best Workers’ Compensation with CF&P Insurance Brokers

Filing a Workers' Comp claim and having it denied is frustrating. Contact the agents at CF&P Insurance Brokers right away to learn more about common mistakes and how you can protect yourself. We have agents who can guide you through the process.

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