Common Reasons for Workers’ Compensation Claim Denials

19 Oct Common Reasons for Workers’ Compensation Claim Denials

If you’ve been injured at work, it’s imperative that you seek the guidance of an experienced Arizona workers’ compensation attorney. Not only can an experienced attorney guide you through the workers’ compensation process, but he or she will be able to assist you if your claim is disputed or denied. Below are some of the primary reasons that workers’ compensation claims are denied in Arizona.

 

The injury didn’t occur at work

 

If your injury was sustained in an off-site accident outside of working hours, then your workers’ compensation claim may be denied.  However, if your injury occurred away from your worksite while you were performing a work-related task, then you should still be eligible for workers’ compensation benefits.

 

Missed deadlines or incomplete paperwork

 

There are a number of conditions that you must comply with to receive workers’ compensation benefits, including meeting certain deadlines and properly completing the required paperwork. For example, your claim must be filed within one year of your injury.

 

The injury was a result of worker misconduct

 

In Arizona, employees are entitled to workers’ compensation benefits regardless of whether they caused their own injuries. However, there are exceptions to this rule. For example, the following behaviors can result in a denied workers’ compensation claim:

 

  • Employee misconduct
  • Working while under the influence of alcohol or drugs
  • Purposely putting oneself in danger
  • Intentional injuring oneself
  • Engaging in dangerous activities that are unrelated to job duties

 

Regardless of which of the above behaviors an employee engages in, it can result in the denial of a workers’ compensation claim in Arizona.

Anyone with a pre-existing injury or condition may have a difficult time proving the validity of his or her claim

Healed injuries

 

If you are injured in a work-related accident, you should see a doctor as soon as possible. By seeking medical attention as soon as your injury occurs, you give your doctor an opportunity to assess your need for benefits. However, if you wait too long to seek medical care, then your physician may report that your injury has completely healed, thus resulting in the denial of workers’ compensation benefits. And while such a decision can be appealed, you must be able to provide evidence that your injury is still in the process of healing and in need of further treatment.

 

 

Prior injuries or pre-existing conditions

 

Anyone with a pre-existing injury or condition may have a difficult time proving the validity of his or her claim. Insurance providers who handle workers’ compensation claims often check applicants’ past medical records. If there is any evidence that your injury may have occurred prior to your work-related accident, then your claim may be disputed.

 

Arizona Workers’ Compensation Attorneys

Workplace injuries can be devastating, both physically and financially. Therefore, if you or a loved one have been injured on the job, it is highly recommended that you contact an experienced Arizona workers’ compensation attorney as soon as possible, as you may be entitled to compensation. For a free consultation, please contact Arizona Injury Law Group, Attorneys at Law, PLLC, at 602-346-9009.

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