Denied Claims

Common Tactics Used to Deny Workers’ Compensation Claims

Insurers responsible for paying workers’ compensation claims can sometimes use unscrupulous tactics to try to deny you the financial compensation you are owed. Some of the most commonly employed tactics by these insurance companies include the following:

• • Dismissing medical evidence: your employer’s workers’ compensation insurance company may argue that you have not provided adequate or credible evidence of your injuries. Even if your doctor provides forms and delivers the necessary information to these insurance adjusters, your claim may still be denied.
  • Arguing that you were at fault: the insurance adjuster for your employer’s workers’ compensation policy may argue that you were under the influence of prescription or non-prescription drugs, alcohol or other substances that could have contributed to your accident. They may also allege that you were behaving in an unsafe way and that your own behavior was responsible for your injury.
  • Alleging a pre-existing condition: in cases where you had already sustained an injury unrelated to your employment, the burden of proof will usually be on you to show that your working conditions made it worse. This is often a reason for denying claims based on repetitive stress injuries or other chronic conditions.
  • Claiming that you did not provide proper notice to your employer: if you have been severely injured at work, it can be difficult to provide proper notice to your employer before receiving medical treatment for your injury. Contacting your employer as soon as possible after your accident, however, should be sufficient to ensure that you qualify for workers’ compensation for your injury.
  • Asserting that you were not injured on the job: if you were injured while driving a vehicle or performing other job-related tasks while not on your employer’s property, insurance companies will sometimes argue that you were not technically on the job at the time of your injury. This is a relatively common reason for initial denial of your workers’ compensation claim.
  • Alleging that you did not file the right paperwork in a timely manner: the insurance company may also claim that you did not file your paperwork or your claim within the allowable time frame. It is important to keep a record of all items mailed and to request proof of delivery services if you send important documents and claim forms through the mail or through a parcel delivery service.

Your employer may also dispute your claim to prevent increases in their premiums for workers’ compensation. This is especially likely if you have no witnesses to the accident or if it occurred at a location outside your workplace. In most cases, working with a qualified attorney who specializes in workers’ compensation claims and appeals can provide you with the best representation and the best chance of success in overturning denials and ensuring that you get the compensation to which you are fairly entitled.

The Right Workers’ Compensation Lawyer Makes a Difference

If your claim for workers’ compensation has been denied, you will need the help of a qualified and knowledgeable attorney to assist you in your appeal. Your lawyer will look over the facts of your case and will provide you with an accurate assessment of your claim. This can help you to determine the right course of action for pursuing your claim. Calling an experienced workers’ compensation attorney as soon as possible after your accident can also prevent issues with paperwork filings and can promote the best outcomes for you in dealing with your claims, your employer and the insurance adjusters assigned to your case.

At the Di Lauri & Hewitt Law Group, we offer practical help for you in dealing with worker’s compensation claims and the tactics used by insurers to deny these claims. Our workers’ compensation attorneys can provide services to clients in Morristown, Cedar Knolls, Morris County and all of New Jersey. To learn more about how we can help you deal with workers’ compensation claim denials, call us today at 973-343-5736. We look forward to the chance to serve you.