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Top 4 Reasons Workers Compensation Claims Are Denied

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Employers are required to carry workers compensation insurance to protect employees in the event that they are hurt while at work. But just because a company has workers comp insurance, it doesn't mean that your claim will automatically be approved if you happen to get injured on the job. There are several reasons why workers compensation claims are denied, so you need to be diligent to ensure that yours is not. Some of the most common reasons workers compensation claims are denied include:

Injury Was Not Reported

If you're hurt at work but don't inform your supervisor, there is a possibility that your workers comp claim can be denied. Ideally, you should immediately notify your supervisor of the accident and an incident report should be recorded. Make sure that you request a copy of the incident report for your own records. If you fail to report the injury immediately, make sure you do so as soon as possible. In most states, there is a statute of limitations for how long you have to report and injury and file a workers compensation claim.

Failure to Seek Medical Care

When it comes to filing a workers comp claim, your word is not enough to verify a workplace injury. If you're injured at work, it is essential to seek proper medical care. Prior to seeing a doctor, speak to your company's HR department; some companies require injured workers so see a specific doctor or go to a certain clinic. In addition to seeking medical care, it is imperative to continue to see the doctor until you are released to return to work.

Evidence of Alcohol or Drugs

In most cases, a person getting medical care for a work-related injury will have to undergo a blood test to check for the presence of alcohol or drugs in his or her system. If your blood test comes back positive for drugs or alcohol, your workers comp claim may be denied because you were under the influence when the injury occurred.

Injury Did Not Happen on the Clock

Workers compensation insurance only covers injuries that happened while on the clock. If you have a pre-existing injury that happened outside of work, workers comp may not approve your claim if you further exacerbate the problem while at work. Workers comp typically does not cover any injuries that occur on the way to or from work, or while an employee is clocked out for a break.