7 Reasons Why Your Employer May Deny Your Workers Comp Claim

Many injured workers reach out to a Louisiana workers compensation attorney only after their workers comp claim was denied by their employer. At this point, you have to be prepared for a long and complex appeal process – made so by insurance companies which try to dissuade employees from challenging a denied workers compensation claim.

However, if your claim is truly valid, an experienced attorney will be able to overturn the denial. Thus, you win the benefits you deserve to pay for your medical care and support your family while you are recovering. Yet, in our experience, there are cases where the workers comp claim denial cannot be challenged. For this reason, we decided to list some of the most common reasons why an employer may deny a claim – both valid and invalid. 

Also, since some of the reasons for denial are errors made by the injured worker, we encourage you to contact a Louisiana workers compensation attorney as soon as possible after your accident. Under their guidance, you will be able to file a valid workers comp claim and avoid making the mistakes that may hurt your case.

Find Out Why an Employer May Deny a Workers Comp Claim 

In our experience, the main reasons why an injured worker got their workers comp claim denied are the following:

1. You Reported the Accident Too Late

Employees must report any workplace accident to the employer within 30 days in writing. Failure to do so will give the employer and their insurance company the reason to claim that you were not as seriously injured as you state. Even if you have suffered severe injuries that keep you in hospital, your Louisiana workers compensation attorney can help you fulfill this legal obligation.

2. Your Employer Did Not Report the Accident to Their Insurer

Employers must report any workplace accident to their insurance company within 10 days after being informed of it. This is done by filling in the First Report of Injury form. While this is a legal obligation, not all employers follow through with it.

For this reason, you need to make sure that the form was duly filled in and submitted. A workers comp attorney can do that on your behalf, and make sure that the insurance company is aware of your upcoming workers comp claim.

3. You Are Not Eligible to Collect Workers Compensation Benefits

Louisiana Workforce Commission specifies the categories of employees who are eligible to file a workers comp claim. Yes, this means that not all categories of workers are covered by this type of benefits.

Some of the excluded categories are:

• Domestic employees, such as nannies
• Real estate salespersons
• Public officials
• Uncompensated officials and directors of certain non-profit organizations
• Volunteer workers.

Also, independent contractors are not eligible to file a workers comp claim. However, it is possible that you were misclassified as an independent contractor while, in fact, you are an employee. This is why it is worthwhile to present your case before a Louisiana workers compensation attorney. As we offer a free case review, you have nothing to lose.

4. You Refused to Take a Drug Test after the Accident

Being under influence of alcohol or drugs would automatically get your workers comp claim denied. For this reason, your employer will require you to take a test before you go to hospital for treatment. Refusing to do so will give rise to the suspicion that you were under influence.

This will make it very hard for your attorney to defend your case. Of course, if you get blood tests done in hospital and they turn out negative for controlled substances, things are different. Your attorney can argue that you were worried about your condition and wanted to get medical care as soon as possible. 

5. Your Employer Claims Your Accident Did Not Happen on the Job

An employer can claim that you were off duty when your accident happened. This does not deny the fact that you suffered an injury, but it is not something covered by workers compensation. 

This type of claim can be disputed by a Louisiana workers compensation attorney using CCTV camera recordings, your time logs and testimonies from eyewitnesses. It is also useful to have your pay slips which indicate frequent overtime payment – which supports the idea that you would often be at work outside your regular shift. 

6. You Have a Pre-Existing Condition

Many workers have old injuries or pre-existing conditions, such as autoimmune diseases. This makes many employers believe that they can deny a workers comp claim, because the respective employee is already injured, and there is no way of knowing if the accident caused any new damage to them.

Actually, this can be easily proven with tests and scans compared to the worker’s tests and medical records before the accident. An experienced Louisiana workers compensation attorney will put together all the necessary evidence to prove your case. If the insurance company still denies your claim, you will win your compensation through an appeal with the state’s Office for Workers Compensation. At the end of the process, you will win not only your benefits, but also penalties up to $8,000 and all the attorney fees.

7. You Refused the Independent Medical Examination

An employer has the right to check the extent of your injuries reported in a workers comp claim. To this end, they will schedule you to undergo an independent medical examination by one of their approved doctors.

You must definitely undergo this check-up and be cooperative with the doctor. While they are not 100% on your side, they will not downplay any severe injuries. Failure to show up for the check-up will give your employer a valid reason to deny your claim.

Let a Louisiana Workers Compensation Attorney Guide You!

At Louisiana Workers Compensation Lawyers, every attorney is highly versed in all the ins and out of the law and in the complexities of different cases. We know that insurance companies are never keen to pay benefits. However, if you have a valid workers comp claim, we will definitely be able to win your benefits, if you follow the rules.

These rules exist to create fairness for everyone – employers and employees. We know that some of them may appear to be a hassle, but they are necessary if you want to win benefits and recover at home without losing your source of income and paying out of pocket for medical care. Schedule a free case review with our Louisiana workers comp attorneys as soon as possible after your accident and let us guide you in filing your workers comp claim: 504-420-2755!