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The Top Reasons Why Workers’ Comp Claims Are Denied

Your workers’ compensation claim may have been denied for a variety of different reasons.

Here’s a hypothetical situation: Some way or another, you were injured at work. This is painful and frustrating on its own, but then it gets worse. Your workers’ compensation claim gets denied! The question you ask yourself is, “why?” In this article, we will tell you the most common answers to that question.

reasons why workers compensation claim was denied

Your Injury Happened Outside Of Work

Workers’ compensation claims can only be made for injuries that happened at work. If your injury occurred outside of work, or your employer thinks it did, they will deny your claim. One area of confusion is when you are not in the workplace but are carrying out a job function. In this gray area, you still might have a case and should speak with a lawyer.

You Missed a Deadline

The two deadlines you need to know about are the deadlines to notify your employer and to file an official claim with the Missouri Division of Workers’ Compensation. The first is thirty days, and the latter is two years. If you fail to meet one of those deadlines, you will have a much harder time getting benefits.

You Were Intoxicated at the Time of Injury

Occasionally, a worker will be intoxicated at work and suffer an injury that they would have sustained whether they were sober or not. More commonly, an intoxicated worker will be less alert and careful, and they will be injured as a result. Either way, your claim will generally be denied if you are injured while under the influence.

You Never Obtained a Medical Assessment

When you are injured on the job, you should obtain a medical assessment right away. If you don’t, then there is no record of your injury and its severity. A medical evaluation is one of the most critical pieces of evidence in your case, so get one as soon as possible if you are injured on the job.

You Went to the Wrong Medical Provider

In Missouri, an injured worker will be required to see a doctor provided by their employer. The employer pays for this assessment, and in all likelihood, it will be fair. That being said, if you feel that the doctor you were assigned is trying to take advantage of you in any way, you can discuss your options with a lawyer.

You Were Injured During Horseplay

To claim workers’ compensation, you will likely need to have been hurt during a typical work activity. If you were hurt do something dangerous like wrestling with a coworker, you will have a hard time getting benefits.

As you can see, a lot can go wrong with a workers’ compensation case. To ensure that the process goes as smoothly as possible, speak with a Kansas City workers compensation lawyer. Your lawyer will advise you before your claim and assist you through the entire process.

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Updated: June 14, 2019

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