Worker’s compensation refers to a system that protects the workers who sustain an illness or injury related to the job. It pays for the medical treatment of the injured employee. The worker’s compensation insurance company of the employer makes the preliminary determination on whether the work-related injury would be approved or denied. It is worth noting that insurance companies could save a good amount of money by denying the claims.
And, when the companies deny claims, they hope the injured worker would take their word that denial is valid and move on. And, numerous frustrated workers do so. According to the workers’ comp attorney, it is crucial to know the reason for the denial before you move on based on the insurance company’s word. There are numerous reasons for the denial of workers comp claims such as
· Injury Not Happened at Work
For receiving the workers’ compensation, the illness or injury need to be the result from duties worker perform during employment. Therefore, one of the key reasons for denial is injury did not occur at the work. However, there could be numerous gray areas with such kinds of issues.
For instance, you are heading out for lunch and the boss gives you cash and asks you to pick up food for you and other workers. On the way to the food shop, you were injured in an accident. In such a case, the insurer might deny benefits as you were ‘off the clock’ during injury. However, even if you were out, you were still doing the work-related duty as the boss instructed you to make the trip.
Injury Not Reported Timely
For every state, there is a certain deadline to report work-related
injuries. The top workers’ comp lawyers in Oakland CA suggest reporting the injury as soon
as possible. However, with several other issues related to worker’s comp,
things are not simple. For instance, certain injuries occur after an extended
period like occupational illness, repetitive stress injuries, etc.
It might take time for you to notice such injuries as well as take the appropriate actions. However, again the insurance companies would take benefit of it and deny the claim in case they could find a reason for saying that you did not report injury timely.
Failure to Seek Immediately Medical Treatment
This is linked to the previous point, you might feel pain in the lower back as you picked a 100-pound box. However, you tried to tough that out, thinking the pain would go away eventually. After few days, you realized something was wrong and you required medical help. In such a situation, the insurance company might say you are faking an injury or it was not serious because you did not get treated for the injury immediately.
The insurance company might even claim you did not do much to mitigate the injury’s extent. In
case you, your friend, or colleague has been denied, do not give up as several
denials are not legitimate. You might appeal your claim successfully and for
that, you require legal counsel. In case you are looking for a reputed California worker’s comp attorney,
the Law Offices of James E. Latimer is the best search result. They don’t even
charge any fee until they earn the client the benefits.
