Why Was I Denied Workers’ Comp?
As a Memphis workers’ compensation lawyer with over 40 years of experience, I’ve seen how frustrating a workers’ compensation claim denial can be for our clients.
After all, you’re already dealing with the physical, emotional, and financial toll of an injury, and being denied the benefits you deserve only adds to the stress.
But don’t give up just yet—there are often ways to overcome a denial and get the compensation you need. In this post, I’ll break down the common reasons workers’ compensation claims are denied and provide strategies for overcoming them.
1. Failure to Report the Injury on Time
One of the most common reasons for a workers’ compensation claim denial is failing to report the injury within the required time frame.
In Tennessee, you generally have 30 days to report your injury to your employer. Any delay in reporting could hurt your claim. If you’re injured at work, you should notify your employer immediately, even if you think the injury is minor.
The sooner you report it, the stronger your case will be.
If you didn’t report your injury immediately, don’t panic. While it’s important to report injuries quickly, some delays can still be excused under certain circumstances. For example, maybe you were unaware of the injury’s severity at the time or were unable to report it because of the injury itself.
A skilled workers’ compensation lawyer can help you present your case and argue why the delay shouldn’t prevent your claim from moving forward.
2. Lack of Medical Evidence
Insurance companies will often claim there’s insufficient medical evidence to support the injury or illness. If the doctor’s notes or medical records don’t clearly link your condition to your work, your claim could be denied.
Make sure to get immediate medical attention and follow your doctor’s orders. Keep records of all medical visits, diagnoses, treatments, and any expert opinions related to your injury.
If the insurance company still disputes your medical evidence, you may need a second opinion from another doctor or an independent medical examiner (IME).
And if that sounds like a lot, our workers’ comp lawyers can help you gather the evidence to back up your claim.
3. Employer Disputes the Injury Was Work-Related
In some cases, employers may argue the injury didn’t occur on the job. This is especially common in situations where an injury develops over time or is caused by repetitive stress rather than a single accident.
If your employer disputes that the injury is work-related, it’s important to gather evidence to show that your job contributed to or caused your injury.
This might include:
- witness statements
- work records
- photos
- or reports from your supervisor.
A workers’ compensation lawyer can help you gather this evidence and present it to the insurance company or in a hearing.
4. Pre-Existing Conditions or Aggravation of an Old Injury
Pre-existing conditions are another common cause of workers’ compensation claim denial.
For example, let’s say you have a back injury from a previous accident and you re-injure it at work. The insurance company might try to argue the new injury is just an aggravation of the old one. They could deny your claim then, even if it clearly happened at work.
But while pre-existing conditions can complicate a claim, they don’t necessarily prevent you from receiving workers’ compensation.
You need to prove that your work duties either caused or significantly worsened your existing condition. This will include gathering medical records that show how your work activities contributed to your injury.
5. Inadequate Documentation
Sometimes, workers’ compensation claim denial happens because of a lack of documentation.
This could include:
- missing forms
- unclear paperwork, or
- incomplete medical records.
By working with a lawyer, you can make sure all your documentation is complete and correct before submitting your claim. This includes accident reports, medical records, and any supporting evidence that links your injury to your work.
Legal Help After a Workers’ Compensation Claim Denial
A denied workers’ compensation claim doesn’t have to be the end of the road. In fact, we’ve found a lot of people just need the right help.
With over 40 years of experience, we know how to tackle all the challenges that come up during the claims process. We’ll fight to make sure your claim is properly handled and that you get the compensation you deserve. And we don’t get anything unless and until we win your case.
Let us help you get back on your feet. If your claim has been denied, contact our Memphis workers’ compensation team online or call us today at 901-327-2100.