5 Things That Will Cause Your Workers Comp Claim to Be Denied

The economy is holding up but that doesn’t mean you are. Are you financially protected? Did you sign up for all benefits to which you are entitled? Have you been involved in an accident at your workplace? An on the job injury can leave you feeling uncertain about the future, especially if you’re facing a long recovery. Unfortunately, your company doesn’t have a say over your Iowa workers compensation claim; the decision over whether to approve or deny it lies with their insurance company. If you want to ensure that your medical and other expenses are covered by your employer’s workers compensation insurance, here are some reasons why.

Forgot to File On Time

Workers Compensation Any injuries should be reported to your supervisor immediately. There’s also a deadline to file a workers compensation claim. This can vary state by state, and by the nature of the injury (think exposure to substances that cause cancer of a disability that occurs over time, like a repetitive motion injury. For example, the statute of limitations in the state of Iowa requires official notice to the employer within 90 days of the onset of the illness or injury and a formal filing within a maximum of two years; the sooner, you file, the more likely you’ll be approved if all other conditions are met. Make sure to check the specific rules of your state.

Company Disputes the Claim

Most companies are supportive of their workers and want to make sure they taken care of after an injury. However, if your employer has reason to believe your injury happened off the job, if you have a pre-existing condition, or the employer may have acted in a negligent manner themselves, they may dispute your claim.

No Medical Report

By law, most employers are required to document workplace injuries of any severity. Even if you feel that you’ll be okay without medical treatment, you may still be required to present documentation by a licensed physician about your injuries and prognosis. It’s sort of like having your home owners or renters insurance deny payment after a break in due to lack of a police report.

Lack of Evidence

If there were no witnesses to the incident and your employer has any reason to doubt your account, such as giving conflicting versions or injuries that don’t match the circumstances, you may be denied your claim.

Positive Drug Test

It’s very likely that Being impaired on the job is usually enough for an insurer to decide negligence on your part. However, if the substance detected is a prescription medication that you’re taking for a legitimate reason, you may be able to appeal the decision. Other substances, like marijuana, can show up in a drug test up to 30 days after use, so you may be able to argue that you were sober at the time of the incident.

Filing an Appeal

If you’ve been denied a claim, you should receive notice in writing with a deadline to file an appeal. This notification may or may not list the reason(s) for denial; if it doesn’t you can contact the insurance company to find out. Your choices are to drop the claim, to try to negotiate with the employer, or to have a licensed attorney file a formal appeal. You’ll gather all of your evidence before speaking to a lawyer, including witness statements and medical reports as well as all correspondence between you the company, and the insurer.

Making sure that you file an accurate claim in a timely manner will lessen the chances of a denial. If you’re having trouble with your workers compensation claim, don’t try to handle it yourself. Contact a local attorney who specializes in employment law.