Worker's Injury Claim Form

Most common reasons why a worker’s compensation claim is rejected

Unfortunately, there can be a variety of different reasons why your claim for worker’s compensation has been rejected. Here are some of the most common:

Your injury did not occur while you were performing your job duties

In order to be eligible to receive worker’s compensation, your injuries must have been sustained while performing the duties related to your job. Those that incur during a lunch break or during your commute to or from work are generally not covered. However, as with most things, this rule does have some shades of grey. For example, if you incur an injury and are driving to a work-related meeting, or if you are at a convention, you could still have your claim reversed. An experienced worker’s compensation attorney can help build a persuasive case on your behalf.

You didn’t notify your employer about your injury

There are numerous different ‘hoops’ that must be jumped through to successfully file a worker’s compensation claim. One of these is that you must notify your employer about your injury as soon as you reasonably can. This enables them to complete an investigation into the accident – something which is essential for your claim. In Florida, you must report most injuries within 30 days, but the sooner you do, the better it looks for your claim.

You didn’t receive medical treatment, or your medical treatment wasn’t provided by an approved medical provider

While your injury may not necessarily seem significant enough to warrant medical treatment if you believe that you might be entitled to worker’s compensation you need to have medical evidence to support your claim. If you try to file a claim without it, it would seem as though you have faked an injury. You also need to make sure that the medical provider that you see is approved under the worker’s compensation system. If the doctor you go to isn’t approved, their medical opinion cannot be considered for your claim.

Your injury was caused by your own irresponsibility

Irresponsibility can mean a number of different things in this respect. You may have been doing something silly at work such as roughhousing or playing a prank that went wrong and, in these instances, your claim is likely to be rejected. Alternatively, if you were found to be under the influence of drugs or alcohol at work, your worker’s compensation claim will almost certainly be denied.

Your employer has successfully disputed your claim

Virtually every employer can and will dispute your claim for worker’s compensation. This is for several reasons. Firstly, they will not want to accept responsibility for an accident that could potentially lead to negative media attention and secondly, the cost of their worker’s compensation insurance could rise if your claim is successful. The fact of the matter is that if your employer builds a stronger case than you can, your claim will be denied. The best way to ensure that this doesn’t happen is to enlist an experienced worker’s compensation attorney who can build you the strongest possible case. They will have the unique knowledge and understanding of what makes a successful worker’s compensation claim and can use this when making your case on your behalf.

The good news is that even if your first claim for worker’s compensation is rejected, all is not lost. If your claim is denied you do have a right to appeal the decision. By ensuring that you hire an experienced worker’s compensation lawyer with a proven track record of success, you can win your appeal and receive the reimbursement that you are entitled to for the damages you sustained due to the negligence of your employer. Contact our offices today for more information or to schedule a no-obligation case review.

Juan Lucas Alvarez

Juan Lucas