Most Common Reasons Workers’ Compensation Claims Are Denied

Posted by: Chris

Most employees in Oklahoma are covered by the workers’ compensation system, which means they are entitled to benefits after a work-related injury. But sadly, many injured workers find it difficult to obtain the benefits they are entitled to by law. Here are some of the most common reasons why workers’ compensation claims are denied:

Missed Deadlines

There are certain deadlines that you must meet in order to qualify for workers’ compensation benefits. For example, the law states that employees must report on-the-job injuries to their employer within 30 days. If you miss this deadline, the insurance company could reject your workers’ compensation claim. 

Non-Work-Related Injuries

The workers’ compensation system only covers injuries that arise out of the course and scope of employment, so the insurance company will deny claims for non-work-related injuries. For example, injuries that occur during meal breaks or in a parking lot outside of the employer’s building are typically not covered. The insurance company often argues that injuries like these are not compensable because they were not sustained as a result of employment-related activities. 

Timing of the Injury

Your employer’s insurance company can also deny your claim based on the timing of the injury. The insurance company does not cover injuries that were sustained before you started working for the employer. Likewise, injuries that occur after you are terminated are not covered by your employer’s workers’ compensation insurance. If the insurance company has reason to believe that your injuries occurred when you were not employed, they will reject your claim.

The Cause of the Injury

The insurance company will want to know how the injury was sustained prior to approving your claim. Unfortunately, the insurer may reject your claim after learning more about how it was caused. For instance, the insurance company will not approve your claim if you were hurt while engaging in horseplay. The insurance company also has the right to deny your claim if you were injured while physically fighting with another employee. These are some of the many reasons why the insurance company may deny your claim after finding out how your injuries were sustained. 

Do not give up if your workers’ compensation claim has been denied. In Oklahoma, you have the right to file an appeal and continue fighting for benefits.

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.