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3 causes of denied workers’ compensation claims

On Behalf of | May 7, 2024 | Denied Workers' Compensation Claims |

For injured workers who may have high medical debts from treatments, therapy and rehabilitation and who have lost wages because of an accident, workers’ compensation benefits can help with these grievances. Workers’ comp can help employees recover from an accident and return to work. 

Injured employees must apply for workers’ comp if they expect to receive these benefits. However, an accident does not guarantee that a worker will receive workers’ comp benefits. A denial could cause a worker to suffer through pain, losses and financial struggles. Here are a few reasons why workers are denied benefits that could help them: 

1. Not enough evidence

A worker needs evidence that an injury is preventing them from working to receive workers’ comp benefits. A medical report or a doctor’s statement can improve a workers’ comp case. If an injured worker is lacking any documentation of their condition, they could be denied benefits.

2. Missing the statute of limitations

In Virginia, a worker has to meet the statute of limitations requirements to receive workers’ comp benefits. They must report their injury to their employer or manager within 30 days of the occurrence of the accident. Then, the worker has 2 years to apply for benefits. Failing to meet the statute of limitations can lead to a denial.

3. An accident happened outside of work

One of the conditions that a worker must meet to benefit from workers’ comp is that an accident must have happened during work hours. If an employee was driving to work and experienced a car accident, they may not be eligible for benefits – unless they were, for example, driving for their job.

Should you appeal a denial?

Injured employees who believe their workers’ compensation case was mistakenly denied can appeal the decision — and that’s an opportunity you should take if your claim is unfairly denied.