Why Are Workers’ Compensation Claims Denied?

In order to receive workers’ compensation benefits, you must show that your injury or illness qualifies for workers’ compensation. Once you report your injury to your employer, your employer will then notify his or her insurance company, and the insurance company will decide whether or not they will pay out benefits. The insurance company will do whatever it takes to not have to pay, so there are several reasons why they will deny your claim. Below are some common reasons for workers’ compensation claim denials.

 1.) The injury was not reported properly and immediately.

Massachusetts’s workers’ comp law dictates that you promptly and fully report any work-related injuries to your employer in writing. This report needs to be detailed and accurate and submitted to your employer as soon as possible. To make sure you have the best chance at receiving the benefits you’re entitled to, including the following in the report to your employer:

  • What the injury is
  • When the injury occurred
  • Where the injury occurred
  • What you were doing
  • How it happened
  • Names of any witnesses

2.) Your injury was not witnessed.

If you have no witnesses, it can be easy for your employer’s insurance company to deny your claim. If at all possible, gather the names of potential witnesses to back up your claim. Of course, this will be impossible if no one actually saw the accident, but talk to your coworkers anyway to see if they saw any part of the accident.

3.) Your injury was not work-related.

Workers’ compensation insurance companies often deny claims if they find that your injury did not occur at work or while performing work-related duties. The insurance company might try and claim that you had pre-existing conditions that caused the injury. However, in many cases, a workplace injury has worsened pre-existing conditions, or you have developed a repetitive stress injury that occurred over a period of time. In these cases, you are still entitled to workers’ comp benefits.

Contact a Massachusetts Workers’ Comp Lawyer

The workers’ compensation legal process can be long and tedious. Don’t go it alone. Contact one of our experienced lawyers to have any of your questions answered, receive advice on legal decisions, and guide you through the process. To get started, receive a free case evaluation from one of our trusted attorneys or call toll free at (617) 379-0016.

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