Disability And Work Injury Lawyers On Your Side

Was your workers’ comp claim denied? 5 possible reasons

On Behalf of | Jan 26, 2024 | Workers' Compensation |

If you’re injured or developed an illness while working, you may be eligible for medical coverage and lost wages if you apply for workers’ compensation. 

However, a workers’ comp claim can be denied. Here’s how:

1. There’s not enough evidence for an injury or illness 

An attempt at a successful workers’ comp claim requires strong supporting evidence that an injury or illness is serious. This often means that the injured or ill worker seeks medical support and gathers records. Failing to gather enough supporting evidence can lead to a denial. 

2. A claim wasn’t made within the statute of limitations

Workers must meet Idaho’s statute of limitations when making a workers’ comp claim. What this means is that workers have 60 to report the injury or illness to their employer. Then, workers have one year to file a workers’ comp claim to receive benefits. Failing to miss the statute of limitations can lead to a denial. 

3. The accident didn’t happen at work

An injury or illness must have developed while working for a workers’ comp claim to be approved. An injury or illness that developed outside of work, such as when an employee was driving to work would likely not be workers’ comp applicable. 

4. The injuries were intentional 

Workers’ comp is a no-fault system. In other words, employees can receive workers’ comp benefits without proving fault. However, if an employee intentionally hurt themselves, then they may not be eligible for benefits. 

5. The medical condition was pre-existing 

Many people have pre-existing medical illnesses and injuries. If a claim is made on a pre-existing illness or injury that was not sustained from a job, then the employee would not be eligible for benefits.  

If your workers’ comp claim is denied, then it can put unnecessary stress on your life. You may need to learn about your legal rights to appeal a workers’ comp claim denial.