Why Would My Workers’ Compensation Claim be Denied?

Posted in Workers' Compensation on July 30, 2021

If you sustain an injury on the job, then you probably expect your expenses to be covered. This includes your medical bills, a significant portion of your lost wages, and possible disability benefits, if necessary. However, there are various reasons why a workers’ compensation claim may be denied by an employer or an insurance carrier. Here, we want to look at some of the main reasons why workers’ compensation claims are denied in Arizona.

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Why Would a Work Injury Claim be Denied?

There are various reasons why employers and workers’ compensation insurance carriers could deny a claim. First, it is important to understand that insurance carriers will do anything they can to limit how much money they pay for settlements. This includes looking for reasons to deny the claim. Some of the legitimate reasons that workers’ compensation claims in Arizona are denied include the following:

Deadline issues. It is crucial to report an injury to an employer as soon as possible. Even though the initial reporting requirements are vague in this state, all injuries must be reported within one year from the day they occur.
Claim filed after termination. In some cases, an employee may file a workers’ competition claim after they have already left the job. Sometimes, there are legitimate reasons for delaying work injury reports, but waiting to file a claim until after termination or quitting could make the insurance carrier assume that the claim has been made out of revenge.
Drug or alcohol impairment. After a person sustains an injury while on the job they may have to submit to a drug or alcohol test to check for impairment. If medical records show that a person was impaired when an injury occurred, the claim will likely be denied.
No witnesses to the injury. If there were no witnesses to the injury, this likely increases the chances that the employer or the insurance carrier will deny the claim. Unwitnessed injuries will not necessarily be unpaid, but they could be more challenging when it comes to securing compensation.
Discrepancy between the accident report and medical records. If there is any discrepancy between the injury report and what the medical records show, this could lead to a delay or denial of the workers’ compensation claim.
Horse playing on the job. If a person is playing around on the job and sustains an injury as a result of their actions, this could disqualify them from recovering workers’ compensation.

However, just because a work injury claim is denied does not mean that the injury victim will not be able to recover compensation. Not all denials are legitimate, and a denial simply means that an appeal needs to be made by the work injury victim. It may also be time for the injury victim to seek out assistance from a skilled attorney.

Reach out to a Phoenix Work Injury Lawyer

IF you or somebody you care about has been injured on the job and are struggling to recover the compensation you are entitled to, you need to speak to a skilled Phoenix work injury attorney as soon as possible. An attorney will be able to step in and examine every aspect of your claim so you can recover the compensation that you need for your losses.

Avery N Crossman

Ms. Crossman is a State Bar Board Certified Workers’ Compensation Specialist and is past Co-Chair of the State Bar Workers’ Compensation Section. She has served as a faculty member at the State Bar Seminar on Professionalism and is a former Judge Pro Tempore in the Arizona County, Justice, and Superior Courts. In the past, she has spoken at seminars on Workers’ Compensation sponsored by the Industrial Commission of Arizona and the Arizona Association of Lawyers for Injured Workers. Ms.Crossman is a long-time member of the Arizona Association of Lawyers for Injured Workers. She is also a member of American Mensa.