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The Most Common Reasons Why Workers’ Compensation Is Denied

The Most Common Reasons Why Workers’ Compensation Is Denied

The good news is that most workers’ compensation claims go smoothly and you receive the financial compensation you deserve after being injured while on the job. The bad news is that insurance companies sometimes deny the claims.

Keep in mind that a denial does not mean there is nothing that you can do. If you are faced with such a situation, contact a Munley Law Wilesbarre workers compensation attorney as soon as possible to get the help you need. To aid you in the process, it helps to be aware of what might go wrong. This is why you should know the most common reasons why compensation claims are denied. They are presented below with a short explanation so that nobody can take advantage of you.

Non-Compensable Injury

This means the insurance company claims your injury does not meet state laws for compensation coverage. Such a thing might or might not be correct. Seeking legal counsel is the easiest way to figure out if the insurance company is right or not. Due to the fact that terms are often vague, a lot of interpretation is possible. Misusing the law is much more common than it should be.

With the help of the workers’ compensation attorney, you can understand your injury and how it is covered by the law. Then, you will figure out what your best option is to obtain the compensation you deserve.

Pre-Existing Injuries

Most employees think that when they suffer from a pre-existing condition, workers’ compensation does not apply. This is not entirely correct. When insurance companies use this reason for the denial, it is usually just a dishonest attempt to try to avoid the payment. In fact, pre-existing injuries stand out as the most common reasons why injury claims are denied.

The attorney once again helps you out a lot since he will let you know exactly what the denial is. The legal representative can also represent you in a meeting with the insurance company. Oftentimes, the simple presence of an experience workers’ compensation attorney will stop the insurance adjuster from even trying to deny your claim based on pre-existing injuries.

Lack Of Medical Proof

Obviously, in order to get compensation, you need to prove that you were injured. Several medical documents can be presented and the insurance company might say that they are not enough or that they do not prove what they have to prove for the damages to be paid.

Insurance companies can review medical history and anything that is related to the workplace injury, together with the treatment.

As you get treated, you will sign several forms and releases. Insurance companies often claim that they did not receive the documents. This is actually quite rare but workers do not know and might agree with what the insurance adjuster says. The workers’ compensation attorney makes sure the adjuster does not take advantage of your lack of knowledge and will actually assist you to gather absolutely all medical documentation needed. If paperwork is not actually present, the attorney will get it for you.