Common Reasons Why Workers’ Compensation Claims Are Denied

Society Arnab Dey Legal 23 January 2023 5 Mins Read
Compensation Claims

Open societies in a democratic framework, like the USA, took all initiatives to support the workers’ points. There are strong laws that back the working class.

Therefore, if you meet with an accident while at work, you are entitled to get workers’ compensation as per the laws and regulations of the country. The workers win, but the companies lose quite a large sum of money as the employees benefit from being vulnerable.

Every state and federal law ensures a balance between the ruling class and the working class. This is the basic right of the vulnerable section. But there are reasons that the workers’ compensation claims are denied.

We think that you need to have a good idea regarding it. The article discusses some common reasons why workers’ compensation claims are rejected.

Common Reasons Why Workers’ Compensation Claims Are Not Accepted

Workers' Compensation Claims

Prior to getting a detailed idea of the reasons for the rejection of workers’ compensation, you need to have a good idea of the basic ideas involved with workers’ compensation. These forms as the basis for your overall understanding.

What is Workers’ Compensation?

Workers’ compensation is a government mandate program that benefits workers who receive injuries while at work. It is a type of disability insurance program for workers. They include providing cash benefits and healthcare benefits to the ones suffering an injury.

The victim needs to prove in court that he\she received the injury when they were working. Establishing this in court fetches the compensation that the employees rightfully deserve.

What Benefits Does A Worker Get When They Are Involved In An Accident In The Workplace?

Involved In An Accident

Employees who meet with an accident while at work get different benefits. According to the International Labor Organization Social Security (Minimum Standards) Convention  1952, the compensations that come under workplace benefits include:

  • Necessary Medical Care.
  • Sickness benefits because of not joining the office.
  • Disability pensions in case there is a loss of an organ.
  • Survivor pensions and the benefits.

These are the International laws that safeguard employees. Besides this, you get different benefits like injury compensations, injury schemes, and other benefits. To know more about this, you must consult workers’ compensation attorneys.

Discussing mainly in the periphery of the USA, there are four kinds of workplace benefits that an employee might receive from the authorities, and they include:

  • Medical Coverage Workers’ Compensation.
  • Vocational Rehabilitation.
  • Death Benefits.
  • Pain and Sufferings.

These benefits help the worker come back on track after the incidents. You can learn more about the laws if you take help from workers’ compensation attorneys.

Now The Reason For The Rejection

That law protects the working sections, which are at the receiving end most of the time. But there are instances when workers misuse the laws to get the upper hand. But in a general sense, certain instances deny compensation to the employees.

Reason For The Rejection

1. Late filing

When you meet with an accident, you need to file a worker’s compensation case before the court. The trial goes on to check out the substantiality of the case. Things are decided thereafter.

The filing takes extensive paperwork and other compliances. They have their own complexities. If you file your compensation benefits late, your filing might be deemed null and void.

The paperwork is challenging, and therefore we recommend you take the help of competent law services. They help you get the desired justice that you need. A reputed law firm has an entire team to work on filing the case.

2. The Injury And Illness Are Not Work-Related

It might be possible that the injury did not take place at work. The filing of court cases for a workplace injury can be denied outrightly if:

  • The injury was caused due to some hobby and recreational activity.
  • There was no witness when the worker met with the accident.
  • The injury or illness occurred and developed due to some preexisting conditions.
  • The accident took place when the worker was going home from work.

Strictly in these cases, the filing of injury claims can be rejected.

3. The Employee Was Intoxicated While On Duty

Workers’ compensation and filing can be rejected if it is found out that the employees were working under intoxication. When you are drunk and intoxicated, your brain signals and reflexes do not really work the way they should have worked.

In that case, the chances of meeting with an accident can be high. Now you can not drink and work in sectors like manufacturing and real estate. This is because these sectors are always filled with high risk and uncertainty. In this case, you won’t be able to get the compensation that you deserve.

4. You Were Not Treated By An Approved Medical Provider

The first thing the employees need to do is get the treatments from a registered physician. It might also be that your treatment required major or minor surgeries.

Things might get risky if you do not get yourself treated by an approved medical or registered care provider. This is one instance when your compensation filing can be rejected by the court.

5. Your Injury Was A Result Of Roughhousing Or Practical Jokes

When working on the ground, especially in risk-oriented sectors, you need to work with the utmost seriousness. But after all, we are all human beings, and we engage in lightness or mood-cracking jokes.

Imagine that during such a light mood, you meet with a serious accident. If it is proved in the court that you were not working and engaged in practical jokes and other light-hearted activities, receiving compensation might be difficult. Not only this, the entire filling can be denied as ineffective.

Closing The Discussion

Accidents can happen at any time. So workers need to be watchful all the time. But sometimes accidents do happen.

In such cases, you are entitled to get medical benefits and other forms of compensation from the authority. But there are instances that your filing might be denied. So, in this case, you need to be aware of the laws and regulations.

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Arnab is a passionate blogger. He shares sentient blogs on topics like current affairs, business, lifestyle, health, etc. If you want to read refulgent blogs so please follow Voice Faction.

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