Workers Comp Claim Denied – What Are My Options?

workers comp claim denied

When you work for an employer in the state of Missouri and they employ more than five workers or are in the construction industry, you are generally covered by workers’ compensation insurance if you are hurt while working. Workers’ compensation insurance is mandatory under Missouri law. This type of insurance tries to ensure that workers will not be burdened by medical bills if they are injured while working.

If you have been injured at work and your claim has been denied, you might be wondering if you are out of luck and unable to recover compensation for your injuries. The answer depends on why your claim was denied.

Common Reasons Why Workers’ Compensation Benefits Are Denied

There are common reasons why workers’ compensation claims are denied, and whether you can fight the denial or not depends on the reasoning for your denial. The most common reasons for denial are:

Failure to Report Your Injury in the Allotted Time

In the state of Missouri, you have thirty days post-accident or injury to report an injury to your place of employment. If you don’t report within thirty days your claim will likely be denied.

Failure to File a Claim in Time

You have only thirty days to file a workers’ compensation claim in the state of Missouri. If you didn’t do so within the thirty-day window, your claim will be denied.

Your Employer Disputes Your Claim

If your employer disputes your claim and insists that your injury was not a result of work-related activities or some other qualifying reason, then the insurance company may deny your claim.

Your Injury Does Not Qualify

There are some conditions that are not covered by workers’ compensation in the state of Missouri. If you have an injury that is not covered by workers’ compensation, like stress, then your claim will not be covered.

Failure to Receive Medical Treatment

To collect workers’ compensation, there usually has to be medical proof of an injury. It is not enough to say that you sustained an injury. You have to have medical documentation to prove it or the insurance company will likely deny your claim.

Lack of Evidence

If there isn’t enough evidence to prove that your injury happened the way that you say it did, then the insurance company can deny your claim.

When to Plead Your Case

If your claim has been denied, there are times that you can fight against it. The best thing to do is to speak with a workers’ compensation lawyer to help you plead your case. If it is a matter of not having the proper documentation, a workers’ comp attorney can help you get the documentation necessary to have prove your claim.

Being denied workers’ compensation is not the end of the road. You may very well be entitled to workers compensation benefits. To learn more about what you may be entitled to give us a call 24/7 at (816) 399-3706 for a FREE case evaluation.
Updated: August 23, 2019