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Common Reasons Why Workers' Comp Claims Get Rejected

Unfortunately, workers’ compensation claims get rejected all too often. Even more upsetting, they’re usually rejected because of simple clerical errors. If you’re seeking workers’ compensation, it’s important to make sure each step of the process has been done, and done correctly.

Missed Deadlines

The most common reason for a denied workers’ comp claim is a missed deadline. It’s important that immediately after an incident, you report it to your job first before filing a claim. Medical paperwork also has to be filed on a very specific timeline — one of the reasons why choosing a physician versed in workers’ comp is critical.

Your Doctor Was Not an Approved Medical Provider

Not every doctor is qualified to treat patients undergoing a workers’ compensation claim. Before visiting a doctor, make sure they understand the intricacies of workers’ comp claims and are approved by your employer and insurance agency.

Disputes Over Whether or Not Your Injury is Work-Related

You slip and fall at work — that’s a pretty obvious work-related injury. You’re struck by a falling object while in the storage room at work — that’s a pretty obvious work-related injury. But what if years after working construction in hazardous buildings, you develop cancer?

Whether or not something is a work-related injury is not always black and white. Conditions or diseases that develop years after you’ve stopped working may qualify as work-related injuries, however, they’re more difficult to prove.

You Filed the Claim After Leaving Your Job

Whether you were fired, laid off, or quit on your own accord, insurance agencies are wary of people who file for workers’ compensation after leaving their job. But if you can prove you had a good reason for the delay — like getting injured the day before being laid off — you can still qualify for benefits. You are also still entitled to workers’ compensation if you can prove you were fired because you filed a workers’ comp claim. This is known as retaliation and is illegal in most states.

We know how to complete the workers' compensation paperwork correctly. Your injuries have to be specifically documented according to certain classification codes in order to be processed by your employer's workers' compensation insurance. For more information, call (248) 230-2918 for Bloomfield, (734) 404-7508 for Plymouth, or simply contact us online.