3 Reasons Your Workers Compensation Claim May Be Denied

Law Blog

If you get injured at work, you can usually file a workers' compensation claim to be reimbursed for your medical bills and some lost wages. However, like any insurance carrier, they may try to deny your claim for a myriad of reasons. In this case, an attorney can be your best ally in getting your settlement. If you would like to know more about why your claim may be denied, so you can determine if you should hire an attorney, keep reading.

1. You Have a Pre-Existing Condition

If you have a pre-existing condition, proving your case can be a little hard. Typically, as long as the accident worsened the condition or caused it to return, you should be covered. However, many insurance carriers may fight to argue the pre-existing condition caused the new condition.

In addition, they may try to argue your pre-existing condition contributed to the new condition. For example, if you wrenched your back at work but already had a pre-existing condition, the insurance carrier may argue you wouldn't have wrenched your back without the pre-existing condition. You and your attorney must prove the accident caused the injury, and the pre-existing condition had little to nothing to do with it.

2. You Weren't Working at the Time of the Accident

If you legitimately were not working at the time of the accident, you probably won't qualify for workers' compensation. However, there are some instances that are a little grey. If you were on lunch during the accident and in the breakroom, you may still qualify for a settlement, even though you weren't working. On the other hand, if you were injured while at a restaurant for lunch, you probably won't qualify.

If you were out of the office running an errand for your employer, you may also be covered. However, this situation could get sticky if you combined personal and work errands. You may also qualify for workers' compensation when you weren't working if a co-worker or employer purposely injured you.

3. Your Actions and Behaviors Caused the Accident

For the most part, even if you caused your own accident, you are still covered. For example, if you spilled some water, forgot to clean it up, and then slipped on it, you're probably covered. However, if you were being particularly aggressive or reckless, such as purposely sliding on the slippery floor, you may not qualify.

Similarly, if you were under the influence of drugs or alcohol at the time of the accident, you probably won't receive any money. Therefore, after a work injury, your employer usually wants you to take a drug test immediately.

Workers' compensation is a great tool. However, just like any insurance carrier, they may try to fight your claim. A workers' comp law firm such as Weaver Law firm can help. If you would like to know more, contact an attorney in your area today.


16 November 2022

Business Law Basics: What Small Business Owners Need to Know

When I started my first small business, I had no idea how much I really didn’t know. I was fully prepared to deal with customers, sell product and even handle complaints and returns. What I wasn’t aware of was that there is so much more to it. I was lacking the legal expertise to protect the company and myself. I wanted others to benefit from my experience, mistakes and lessons learned, so I started this blog. From employment law to the legal business contracts you’ll have to sign when you form partnerships, business law is complex. I hope that the information here will help you to be better prepared when you start your business so that you’ll know when you need to call an attorney and when you can handle things yourself.