Can a Workers’ Compensation Claim in Arizona be Denied?

If you were injured while on the job, chances are good that your claim will go through, regardless of who caused your injury at work. Your employer’s insurance company must review and accept or deny your claim within 21 days after receiving official notification from the Industrial Commission of Arizona (ICA). Yet, there are surrounding circumstances in which your claim may be denied. They also do not need to tell you why other than they denied it.

Circumstances Under Which Your Claim is Denied

• Failure to notify the employer in a prompt fashion

Workers may fear to tell their employer that they were injured, such as a shoulder injury or a back injury, or minor blow to the head, especially if they can still reasonably do their work. The fear stems around being fired for “another reason” such as being late one day, or there were no witnesses to the event, so there is no official proof.

You should file your claim regardless of any fears, as you may have an injury that gets worse as time goes by, that negatively affects your work production. Check to see if your company uses CCTV throughout the workplace, as there may be video evidence that verifies that you were injured. Always note down exactly when your accident occurred so you can check the video footage, which will give you the evidence you need.

• Idiopathic condition

If your back is injured while at work and x-rays show that you have a spinal deformity (scoliosis) that may have been present before the current back injury, you may have your claim denied. It will depend on the degree of the back injury incurred during the accident at work. Your doctor’s exam findings may give more information to help you win your claim and benefits.

• Violation of Rule

The employer’s safety regulations are meant to be followed by all employees to avoid injury on the job. There are occasions where a step in a process is bypassed by accident, or due to sudden surrounding circumstances.

It is on the employer to prove that the employee committed willful negligence leading to the injury, or that the employee committed a self-inflicted injury for one reason or another.

Contesting the Claim Denial

Arizona’s Workers’ Compensation infrastructure is a “no-fault” system where compensation benefits are provided to employees regardless of how the injury occurred unless the employer can prove the injury was self-inflicted. If an employer is not carrying employee insurance at the time of an injury on the job, the employee can still file for benefits from the ICA. If accepted, the ICA and its Special Fund division will pay the benefits and charge the employer for reimbursement plus penalty interest. The employee can also file a civil lawsuit against the employer.

You can find an expanded list of reasons here for why your claim may be denied. Call us at once if you need help with your denied claim. 602-346-9195