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4 reasons why people are denied workers’ comp

On Behalf of | Oct 19, 2023 | Workers' Compensation

Employees can receive workers’ compensation benefits if they suffer workplace-related injuries or illnesses. They can provide medical coverage and cover some lost wages.

Employees don’t immediately receive benefits after an injury or illness. They must first make a claim. Even if it’s clear that someone is entitled to workers’ comp benefits, a claim could still be denied. Here’s how.

The employee didn’t report the injury in time

Injured workers have a limited amount of time to report their injuries. The statute of limitations to file a report to an employer in Louisiana is 30 days after the injury. Injured workers have three years to file a workers’ comp claim. If this deadline is not met, then a claim could be denied.

The injury wasn’t work-related

Workers’ comp is only available if an injury happened while performing work duties. For example, if a worker suffered severe head injuries from a slip-and-fall accident while working in a warehouse, then they likely will be eligible for workers’ comp. If a worker left work and suffered a car accident while driving home, then it’s unlikely they would be eligible for benefits.

An injury was a pre-existing condition

Many people suffer injuries and medical conditions throughout their lives. A job may worsen or trigger an employee’s injury or illness. In some cases, an employee who files for workers’ comp could be denied if it’s determined that their injury was a pre-existing condition. A worker may need to prove that their pre-existing condition worsened because of a job.

The injury is not serious enough

Workplace injuries can range from minor to catastrophic. If an injury is not serious, then a worker could be refused workers’ comp benefits. For example, a bruise likely wouldn’t make an employee eligible for workers’ comp. A workplace injury may need to cause an employee to be unable to work before they receive benefits.

A workers’ comp claim denial can have a huge impact on an employee’s life. Workers may need to learn about their legal options when disputing claim denials.

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