4 reasons why a workers’ compensation claim might be denied

by | Mar 25, 2022 | Workers' Compensation

If you have gotten hurt on the job, you probably take some comfort in the possibility of collecting workers’ compensation. After all, these benefits are available to injured workers to cover medical expenses and at least a portion of lost wages, which can come of great relief to someone who cannot return to work right away.

This is why it can be so upsetting to learn that a claim for workers’ compensation has been denied. Unfortunately, denials can and do happen to people who deserve this coverage. Below are some of the common reasons why claims can be denied, and what you can do to avoid it.

  1. Claimant is ineligible: While most employees are covered under workers’ compensation insurance in Florida, there are some who are not. Before you submit your claim, ensure that are indeed covered.
  2. The injury was not suffered in the course of employment: If a judge feels that you have not proven your injury is work-related or that a work accident was the major contributing cause, you may not be awarded benefits. Supporting documentation and a clear argument can help avoid a denial for this reason.
  3. There is not enough medical evidence: Much of your claim depends on the medical evidence you submit. If you do not provide sufficient documentation, a judge may deny your claim.
  4. The claim was not filed properly: There are statutes of limitations and other filing requirements with which you must comply. Failure to do so could mean loss of benefits.

Too many people make the mistake of thinking that all they need to do is submit a form and wait for their compensation, but the fact is that it is a complicated process, and there are many opportunities for a judge to deny benefits.

But before you lose hope or assume there is nothing you can do to avoid denials, remember that you can work with an attorney to minimize the chances that your workers’ compensation claim will be denied for these or similar reasons. Legal guidance can give you confidence that you have a complete, accurate application and help you avoid costly mistakes that put your benefits in jeopardy.