What to Do If Your Workers’ Compensation Claim is Denied


Posted by: Chris

If you’ve been injured at work or have developed a medical condition due to your occupation, you may be wondering if you are entitled to workers’ compensation benefits.  Since most Oklahoma employees are covered by the state’s workers’ compensation system, chances are that you are eligible for benefits because of a work-related injury or illness. 

But what if your claim is denied?  It is not unusual for employers or their insurers to look for reasons to deny workers’ compensation claims under the law.  Some of the most common reasons for claim denials include:

Missing a deadline.  You must report any work-related injury to your employer within 30 days.  A claim for workers’ compensation benefits must be filed within one year from the date of the injury or death, or within six months from the date of payment of any compensation or wages in lieu of compensation.

Dispute over the cause of your injury. Your employer may dispute whether or not your injury was work-related.  Even though fault is not a factor for workers’ comp benefits, if you were injured through your own negligence or misconduct, your employer may decide to fight your claim.

Claim filed after you left your job.  Insurance companies will typically deny claims that are filed after an employee has quit, been laid off, or fired.  Injuries sustained prior to your starting work for an employer or after you leave are not covered by the employers’ workers’ compensation insurance. There are some exceptions -- for example, it is illegal for an employer to fire you in retaliation for reporting a work-related injury.  If that occurs, you should consult with an experienced workers’ compensation attorney to find out your options for pursuing your claim.

Injury requirements not met. In Oklahoma, you must have a “compensable” injury or illness to be eligible for workers’ comp benefits.  Under Oklahoma law, “compensable injury" is defined as  “damage or harm to the physical structure of the body, or prosthetic appliances, including eyeglasses, contact lenses, or hearing aids, caused solely as the result of either an accident, cumulative trauma or occupational disease arising out of the course and scope of employment.”

What to do if your workers’ comp claim is denied

Approximately 70% of first-time workers’ comp benefits applications are denied, so don’t give up. In Oklahoma, you have the right to file an appeal and continue fighting for benefits.  Your appeal will be heard by the Workers’ Compensation Commission and you will need to gather evidence to show you have a valid claim under Oklahoma law since the burden of proof lies with you.  This can be challenging, especially when you are in the process of treatment for your injury. Since the appeals process is complex and legal in nature, it would be to your benefit to speak with an experienced Oklahoma workers’ comp attorney to represent you at the hearing or help you negotiate a settlement.

Has your workers’ compensation claim been denied? If so, contact Armstrong & Vaught, P.L.C. at once. Let our experienced attorneys assist with your appeal to secure the benefits you deserve. Call us now at 918-582-2500, toll-free at (800) 722-8880, or contact us online for a free consultation with a skilled attorney.