Workers’ compensation systems are designed to support workers who are hurt on the job. These systems provide compensation to workers who have lost wages due to their injuries and also other benefits, such as healthcare support. 

Workers’ compensation systems do not require the injured employee to prove negligence by their employers. In most cases, this is exactly how workers’ compensation works.

Still, employers may cause delays or even deny workers’ comp claims. Here, we will consider some of the reasons why your workers’ compensation claims are denied and what you can do if your employer decides to fight your claim after a workplace injury.

The attorneys at the Matt Fendon Law Group are experts at representing workers whose employers have denied their claims. If this has happened to you, call us at (800) 229-3880 to speak with a workers’ comp attorney and set up an appointment to evaluate your compensation claims and legal options.

Why Do Employers Deny Workers’ Compensation? 

Workers’ compensation benefits are a form of insurance. As such, employers will often treat workers’ comp claims as insurance claims and allow the insurance companies to manage settlements. This is partly a matter of convenience and partly because workers’ compensation does not allow many ways to contest a valid claim.

What are some exceptions to this general rule of employers not fighting workers’ comp claims? Below we address some of the more common grounds for why your claim may be denied.

Technical Reasons to Deny Your Claim

An employer may attempt to deny your compensation claim because they believe a defect or mistake in your claim invalidates it. 

For example, an employer can contend that you did not file your claim on time or that you did not seek medical treatment – two requirements for your claim to be accepted.

Deadlines and timelines vary by state and can be confusing if you are unfamiliar with your state’s requirements. If you miss any of these deadlines, the employer can challenge your right to receive workers’ compensation benefits.

In some cases, the employer might argue that despite being a real injury, the injury sustained is not covered under the company’s workers’ compensation insurance policy.

In others, employers may attempt to deny a claim if they believe you were injured while not acting within your role as an employee. Workers’ comp only covers work-related claims. Examples of how this can happen include:

• Acts by third parties that injure you outside of your work
• Unforeseeable events like an “act of God” that cause you injury, like an extreme weather event or other natural disasters

Behavior-Based Reasons to Deny Your Claim

Even if you comply with all the procedural requirements to prepare your benefit claims, your employer can still dispute your claim based on the contention that you did something that contributed to your injuries.

Examples of conduct that an employer might use to disqualify you from workers’ comp benefits include:

• Failure to report the injury in a “forthwith manner.” If you do not report your injury within a “reasonable period of time” the insurance company could deny your claim. 
• Pre-existing conditions. If you had a major medical condition similar to the one you sustained on the job, they could deny the claim based on a pre-existing condition. 
• Fraudulent Claims. If an employee attempts to file a claim based on an injury that does not exist, an injury that was not sustained during their work duties, an injury that was a pre-existing condition, or an injury that was intentionally self-inflicted, their claim can be denied.

Can Your Employer Wrongfully Deny Your Claim?

Although many reasons a workers’ compensation claim can be denied are based on the employee’s activities, there are ways that an employer can wrongfully deny your claim. Specifically, this can occur if the employer is at fault for wrongdoing that resulted in injury. For example: 

• Your employer is obligated under state law to carry workers’ compensation insurance but fails to do so.
• Your employer caused or contributed to your injury through intentional conduct and then denied your claim.
• The employer does not forward your claim to the workers’ comp insurer within the time frame it is supposed to.

Talk to a Workers’ Compensation Lawyer About Your Denied Claim

At Matt Fendon Law Group, we understand that workplace injuries can cause severe physical, emotional, and financial difficulties in your life, even when your employer is not challenging your claim. Our Arizona workers’ compensation attorneys are dedicated to giving the best service to clients with workers’ comp claims.

Call Matt Fendon Law Group to speak directly with an experienced lawyer who has a full understanding of the workers’ compensation system. Your workers’ compensation attorney will give you the best legal representation if you must sue your employer, the insurance company, or both.

Our skilled and compassionate attorneys will be there for you every step of the way, from dealing with the insurance provider, gathering evidence of your work injury, and making oral arguments in court until your workers’ comp claim denial is resolved.

Call now to schedule a free consultation at (800) 229-3880.