Suppose you filed a claim for workers’ compensation, maybe due to a work injury, a repetitive strain injury (RSI), or lung disease caused by exposure to toxic chemicals, and the claim was not approved. In that case, you need to study the reasons that may have caused this rejection. After reviewing these reasons, you have the right to challenge that decision by filing an application for adjudication of the claim. It is important to note that there is a deadline for submitting the necessary documents.
In most cases, both the employer and their insurance companies will look for any possible reason to deny workers’ compensation claims. Of course, that reason must be valid under the law.
Here are some reasons for denial of a workers’ compensation claim:
- Missed deadlines: To comply with the corresponding times for filing a claim, it is necessary to know each state’s deadline. If not, you may be penalized for not delivering the report on time. In general, the employee must notify their employer of the injury or illness immediately (preferably in writing).
- Disputes about whether the injury is work-related: In most cases, the employer and their insurer will try to show that the injury or illness was not caused in the workplace. If this is your case, we recommend that you gather evidence to prove your claim’s validity. This evidence may include witnesses or further medical examinations.
- Your condition does not meet state guidelines: Each state has different requirements that endorse or rule out workers’ compensation benefits for illnesses caused by long-term emotional stress at work. Your injuries may not be severe enough to qualify for a workers’ compensation claim.
- Filed the claim after leaving your job: Insurers generally deny claims that were filed after the employee was fired or resigned.
If you think you need legal support during this process, we invite you to contact Grupo Via Dorada today. We are here to provide professional support.