Common Challenges to Workers’ Compensation Claims

To keep pace with costs in an ever-changing industry, employers may seek any avenue possible to challenge workers’ compensation claims and to shift the burden of accountability.

The most common reasons for denial of a claim include failure to notify your employer of an injury within the appropriate time period, and failure to prove that the injury arose out of and in the course of work.

Here are a few additional areas where your employer and/or their insurer may try to leverage their position in order to decrease or even eliminate your benefits:

• Failed drug test
• Misrepresentation on your job application
• Injury did not happen at work
• Varying accounts of the claim by the employee, witnesses, and medical professionals
• Multiple prior accidents
• Injury inconsistent with the nature of the employer’s business
• Date, time, and place of accident is unknown
• Refusal to communicate with employer representatives, medical professionals or their insurance company
• No witnesses to the accident
• Reports from an employer-sponsored/biased physician
• Fraud of any kind

Fraud comes in a variety of forms on either side of a claim. Employers can also misrepresent material facts in regard to your claim and which could limit access to quality medical care. If your employer is trying to challenge your claim in any way, it is definitely time to talk to an experienced workers’ compensation attorney.