Workers’ compensation, which might also be referred to as workers’ comp, is a kind of insurance which ensures that employees are provided with wage replacements as well as medical benefits in case of work injury or severe sickness. However, sometimes a few actions of employers can lead to workers’ comp claim denied. Therefore, employees and employers both should understand the gravitas of the situation to ensure its fairness.
Types of Employer Actions that can Lead To a Workers Comp Claim Denied
We will delve into the types of actions taken by employers that can lead to Workers’ Comp Claim denied.
- When you Fail to Report the Injury on Time: It is very crucial to report the work injury in a timely manner, otherwise it can lead to workers’ comp claim denied. While it is the duty of the employees to inform about the workplace injury on time, the employers are also supposed to be responsible regarding this matter and should avoid delaying and failing to inform the injury provider.There are usually different deadlines on workers comp claims in different states within which the employer has to report the injury.
- Identification of Employees: Another action that can result in a workers’ comp claim denied is the act of classifying employees by their employers. There might be cases where employers, to save various costs, have classified full-time employees as independent contractors. According to work injury laws, independent contractors are not eligible for workers’ compensation benefits. If the employee goes against this legally, and the employer persists that the employee is an independent contractor, then it can lead to workers’ comp claim denied.
- Disputing the Work-Related Nature of the Injury: Employers sometimes challenge the validity of a workers’ comp claim by disputing that the injury was work-related. This might involve asserting that the injury occurred off-site, during off-hours, or while the employee was engaged in activities outside the scope of their job duties. It becomes a matter of proving whether the injury truly happened on the job or not. Employers who actively challenge the work-related nature of injuries may cause workers’ comp claim denied initially, forcing the employee to engage in lengthy legal battles to prove otherwise. A workplace injury attorney might be needed in such a case.
- Alleging Employee Misconduct: Allegations of employee misconduct can lead to workers’ comp claim denied. If an employer can demonstrate that the injury resulted from reckless or intentional actions by the employee, they may argue that the employee should not be eligible for benefits. Common forms of employee misconduct that can lead to a denied claim include violation of company policies, horseplay, and intoxication or drug use. A workplace injury lawyer might be needed in such a case.
- Providing Incomplete or Incorrect Information: Another way an employer’s actions can lead to a workers’ comp claim denied is through the provision of incomplete or incorrect information to the insurance company. This can happen either unintentionally or deliberately. Moreover, if an employer under-reports payroll or misrepresents the number of employees in order to reduce their insurance premiums, they could be creating a scenario where workers’ comp claims are more likely to be denied when they occur. A work injury attorney might be needed in such a case.
Wrapping Up
Benefits of workers’ compensation are made in such a way that it safeguards both the employees and the employers during workplace injury. However, few actions taken by employers, which might be intentional or unintentional, can lead to workers’ comp claim denied. It might be delaying injury reports or workplace disputes; these actions hamper the employees from getting their rightful benefits.
At Hollingsworth & Hollingsworth APC, we have a team of experienced work injury lawyers and best workers’ comp lawyers. Our work injury law firm has injury-at-work lawyers who can maximize your chances of getting the benefits of workers’ compensation as fast as possible, avoiding any action that leads to a workers’ comp claim denied. Contact us today and get a free consultation from the best workers comp lawyer at (619) 374-9320.
