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4 reasons your workers’ comp claim may be denied

On Behalf of | Oct 14, 2024 | Workplace Accidents

When you’re injured on the job, you rely on workers’ compensation to cover medical expenses and lost wages. However, not all claims are approved, and understanding why a claim might be denied can help you avoid common pitfalls. 

Below, we explore some of the main reasons workers’ comp claims are often denied and how you can take steps to prevent these issues.

1. Filing the claim late

Timing is critical in workers’ compensation. Many claims are denied simply because they were filed too late. In Missouri, you must report the incident, accident, or injury within 30 days to your employer. 

If you delay notifying your employer or filing your claim, you could miss the window of opportunity, leading to a denial. To avoid this, report your injury immediately and stay on top of all deadlines.

2. Lack of sufficient medical evidence

A workers’ compensation claim hinges on solid medical evidence proving that your injury is work-related. Claims may be denied if the medical records are unclear or incomplete or if you didn’t seek medical attention promptly. To strengthen your case, ensure you receive immediate treatment, follow all medical recommendations, and keep detailed records of your treatment and symptoms.

3. Disputes about the cause of injury

Employers or insurance companies may deny your claim if they dispute whether the injury occurred at work. For example, if there were no witnesses or you delayed reporting the injury, they might argue that it happened off-site or wasn’t work-related. To counter this, provide as much detail as possible, including witness statements or supporting documents, to establish a strong connection between your injury and your job.

4. Failure to follow employer guidelines

Workers’ compensation claims may also be denied if you fail to follow your employer’s established injury reporting procedures. Most companies have specific guidelines for reporting incidents; if these aren’t followed correctly, your claim could be in jeopardy. Always ensure you understand and adhere to your company’s reporting process to prevent any issues.