Common Reasons for Workers’ Compensation Denial

Reasons for Workers Compensation Denial

Even if a workers’ compensation claim seems like a guarantee, there are seemingly endless reasons that a claim could be denied.

Reasons for Workers Compensation Denial

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  • Pre-existing injury – An employee who has been previously hurt may aggravate his injuries while performing his job. Employers typically use the pre-existing injury defense to deny a worker’s claim.
  • Offsite injuries – A worker can file a claim for workers’ compensation benefits for injuries sustained on the job, even if the injury happened outside of the workplace. In these cases, however, employers and insurance companies may question the merits of the claim, arguing that any injury sustained offsite should not be covered. If the injury occurred while an employee was performing official duties, a skilled and experienced workers’ compensation lawyer may be enlisted to help establish that the worker is eligible for benefits.
  • Injuries with no witness – Unfortunately, fraudulent workers’ compensation claims are common, making employers and insurers wary about injury claims with no witnesses. This poses a problem for people who often work alone. An injury could have occurred exactly as described by the injured employee even when there is nobody to corroborate it.
  • Injuries from horseplay – Workers’ compensation provides a broad range of protection to Georgia workers. Most workplace injuries are covered regardless of who is at fault, but injuries resulting from workers’ horseplay have been denied.
  • Delay in reporting – Some workers may not report their injury immediately, thinking that the physical discomfort will pass. If the injury does not go away or flares up later, these workers may seek medical treatment after a deadline has passed.

Whatever the reason for denial, a skilled and experienced workers’ compensation lawyer in Georgia can challenge the decision and help injured employees get the benefits they deserve.

Reasons Why Your Workers' Compensation Claim Was Denied