Workers compensation is a required insurance plan provided by the employer to pay employee benefits for job-related injuries, disability or death that occur during the course and scope of employment. Most workers’ compensation claims are claimed and received without any issue. However, a claim may still be turned down by a company even when an employee is legitimately injured on the job. We’ve seen first-hand how frustrating and strenuous a situation like this can be on an individual and their family. Our personal injury attorneys shared the most common reasons for a denied workers’ compensation claim:
You were injured somewhere other than work
Workers compensation laws and benefits are available to workers who are injured while in the course and scope of their job. This means that an employee must be injured at work or during the course of a work-related activity. Lack of evidence may cause an employer to allege that the injury happened somewhere other than at work.
Your claim was submitted too late and the notice issue period has expired.
The First Report of Injury is required to be filed no later than 30 days after the injury occurred for workers in Missouri (20 days for workers in Kansas). It’s important to report the injury immediately after a work-related incident.
Your claim was denied because you were under the influence of drugs or alcohol.
Drugs and alcohol almost always causes a claim to be denied because a worker may have been able to prevent the injury if they were not under the influence of drugs or alcohol. In most cases, the employee also agreed to perform their job duties without drugs or alcohol in their system.
Your claim was denied because you did not seek medical treatment.
The insurance company handling your claim may request medical documents that relate to the incident. Though it may be intrusive to some, they have a right to collect information about your injury, medical treatment, and any pre-existing conditions that may have an impact on the claim. Failure to disclose medical information related to your workers’ compensation claim may be grounds to deny a claim. Speak with your employer before seeking medical treatment. Your employer may reserve the right to pick your health care provider.
Your claim was denied because a pre-existing condition or underlying health issue (idiopathic) caused the injury.
Insurance companies may try to argue that your claim of a current injury was pre-existing and instead due to your previous injury or that it occurred because of an underlying health condition, such as high blood pressure, stroke, or a heart attack unrelated to your employment
Workers' compensation laws vary depending on the state in which the incident and injury occurred. We have provided resources below for workers’ compensation cases in Kansas and Missouri. Contact us if you to speak with one of our experienced work comp attorneys.
- Missouri Workers Compensation Resources:
- Kansas Workers Compensation Resources:
Hurt on the job? Learn more about reporting a workplace injury to your employer.
If you've suffered from a workplace injury in Kansas City, you need a Kansas City workers' comp attorney who knows the laws in both states and can help you with all the intricacies of filing a claim. Our attorneys can help. Contact us today to get started!