When workers get injured or sick while on the job, they might be entitled to workers’ compensation, workers’ compensation can cover many expenses, including immediate and future medical bills and lost wages. Ideally, receiving workers’ compensation should be straightforward, with no resistance or backlash from the employer or insurance company. But unfortunately, issues can occur, and many workers are surprised to find their claims denied. In this blog, we’ll explore common reasons why your workers’ compensation claim was rejected and steps you can take should this happen.
- You’re Not Eligible For Workers’ Compensation
While workers who work full-time at a job usually are eligible for workers’ compensation, this isn’t always the case. The size of a business or workplace can determine if you’re eligible. Additionally, many workers are contractors or temps and may not qualify. Lastly, in some states, the following types of workers often don’t allow:
- Casual workers
- Business owners or partners
- Real estate agents
An attorney can help determine if you’re eligible for workers’ compensation.
- The Incident Didn’t Happen While at Work
To be eligible for workers’ compensation, the accident or sickness must have happened while on the job. However, this doesn’t necessarily mean you had to be working on-site. For example, suppose your job involves driving a company vehicle, and you have an automobile accident. In that case, you should still be covered under workers’ compensation even if the accident didn’t occur on the job site.
- You Didn’t Report the Incident Soon Enough
Following an accident or sickness, you should report the situation to your employer as soon as possible. There’s a statute of limitations for reporting a workers’ compensation claim, and this time can vary across different states. For New York, this period is within 30 days. Reporting the incident after this period can result in losing your workers’ compensation benefits.
- You Have a Preexisting Condition, or There’s Not Enough Evidence
The most successful workers’ compensation claims are usually when a worker has a specific accident like falling from a ladder, machine entanglement, falling objects, etc. However, misfortunes come in many forms, and repetitive motions can injure a worker. Additionally, a worker can develop a disease from exposure to harmful chemicals while on the job. Unfortunately, the latter issues are harder to prove. Besides sometimes not being enough evidence, an employer may try to say a worker has a preexisting condition. Sometimes, employers will exaggerate or fabricate a worker’s preexisting conditions, which is when you need help from an attorney.
- A Worker Engaged in Unprofessional Behaviors
If a worker was injured while under the influence of drugs or alcohol, violated safety guidelines, engaged in “horseplaying”, etc., then their claim can be denied. Generally, it can be difficult to appeal when a workers’ compensation claim is denied for these reasons. However, workers’ compensation lawyers, can help if there was foul play. A workplace can fabricate a story to deny your claim. Our friends at Polsky, Shouldice & Rosen, P.C can help if your workers’ compensation gets denied.