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Understanding why a workers’ comp claim could result in denial

On Behalf of | Jan 19, 2018 | Workers' Compensation

Workplace accidents are a serious concern for many individuals, regardless of the nature of their employment. If you suffer serious injuries in a work-related incident, the high cost of medical expenses and the potential of taking time off work during recovery could leave you with facing substantial financial hardships.

You could be entitled to relief through the workers’ compensation insurance system, but the application process can be exceedingly complex. Along with being stressful and intimidating, approval of your application isn’t necessarily guaranteed, and receiving a denial can be a devastating experience.

Appealing a decision for workers’ compensation

The first step to appealing a decision is to understand why your claim may have resulted in denial. While this can occur under a variety of circumstances, some of the more common reasons a claim may result in rejection could include the following:

  • Timing of claim:  Following a workplace injury, you must file a claim for workers’ compensation within a certain time frame. Failing to report your injury or file your claim within the given period could result in a rejection of your claim.
  • Employer disputes claim:  In some cases, your employer may dispute your claim, whether on grounds that your injury is pre-existing or that it took place in violation of company safety procedures.
  • Injury isn’t work-related:  Your eligibility for benefits may also depend on how you suffer your injury, and if it occurs outside of work, or during an action that isn’t work-related, your claim may result in denial.
  • Medical attention:  The timing and place of your medical care may also play a role. Failing to pursue treatment soon after the injury, or obtaining treatment from a doctor that operates outside your employer’s insurance network, could prove detrimental to your claim.

Even if you understand what led to the decision, the appeals process can be challenging to navigate. With a great deal on the line, it could be in your best interests to speak with someone who is knowledgeable in Louisiana’s workers’ compensation laws for guidance.

Seeking advice and assistance

Whether in the initial application process, or during an appeal, pursuing benefits for your workplace injury could prove a daunting task. However, you don’t have to attempt the process alone, and it may be advisable to seek guidance from someone with experience in such complex matters. By obtaining advice early on, you could become better prepared to pursue the benefits to which you’re entitled and work toward your recovery with financial peace of mind.


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