Possible reasons for denial of a workers compensation claim
Unfortunately, just like with regular insurance claims, workers’ compensation claims are denied on a regular basis. At Carey & Hamner, P.C., our experienced lawyers advocate for the rights of injured workers when they are wrongfully denied their workers’ compensation benefits. If you were recently injured in a work-related accident in Dothan, Enterprise or Ozark, and if you were wrongfully denied your benefits, our accident attorneys can help you determine the reason for the denial, and petition for an appeal so that you may recover the compensation you deserve.
Possible Reasons For A Denial
There are many reasons that the insurer may have issued a denial of your workers’ compensation benefits, many of which are undoubtedly unfounded. Unfounded or no, the five most likely reasons that your claim was denied include the following:
1. There Were No Witnesses To Your Injury.
Workers compensation insurance agencies rely on witness testimonies to determine whether or not a workplace accident took place. Without a witness testimony, it can be tough to win your claim. To increase the likelihood of winning your workers’ compensation claim without witness testimony, be sure to report the injury to a supervisor and coworkers immediately. Prompt notice to your supervisor is a required element of any workers compensation claim in Alabama, so make sure you report all claims as soon as possible.
2. You Forgot To File An Incident Report.
If you did not file an incident report immediately after your accident, the workers’ compensation insurance company might have assumed that your injuries weren’t as bad as you claimed for them to be. Alabama law requires notice to your supervisor as soon as possible. Failure to promptly notify your employer may be grounds for denial of the claim. To eliminate any doubt as to the seriousness of your injury and its cause, file an incident report immediately after a workplace accident.
3. Illegal Drugs Were Found In Your System.
If you were rushed to the hospital after a work-related accident, and if your blood sample indicated that there were illegal drugs or alcohol in your system, your case may be thrown out the window. Because drug and alcohol abuse are prohibited in the workplace, it will be assumed that the substances were the cause of your accident and that employer negligence was not at fault.
4. You Filed A Claim After You Were Fired Or Laid Off.
Workers’ compensation insurance companies are wary of claims that come after an individual has been laid off, as it’s easy to assume that such a claim was filed strictly out of revenge. If you filed a claim after being fired or laid off, you must work extra hard to prove to the judge that you really did sustain a work-related injury.
5. You Refused To Cooperate.
The insurance companies typically need several items to follow through with a work accident claim, including copies of your medical records, copies of your statements, and copies of any eyewitness accounts. Additionally, the insurance companies will ask you to sign medical authorizations that will grant the insurer access to communications with your medical provider. While you are not required to cooperate with the insurance company, it would be in your best interest to do so, as doing so will build their trust in you and prove to them that you have nothing to hide.
If your workers’ compensation claim has recently been denied, contact the accident attorneys at Carey & Hamner, P.C. to learn more about your available legal options. To schedule a consultation, call (855) 435-4797 today.