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Situations in Which Your Employer Can Decline Worker’s Compensation

On Behalf of | Oct 27, 2018 | Workers' Compensation

If you have been hurt at work, typically you will file a worker’s compensation claim that will be forwarded to your employer’s worker’s compensation insurer that they are required to have by law in most professions. However, there are certain situations that may find your claim denied by your employer or the worker’s compensation insurance company for one reason or another. If you are already hurt, having a claim denial can be more stress that you don’t need.

However, there are only a handful of situation in which you can be denied. Knowing why you were denied and if it is valid or should be fought against can take just a little bit of guesswork out of your case.

Worker’s Compensation Insurance Doesn’t Cover You

Not every worker is covered by worker’s compensation. A widespread example is the independent contractor that is often not covered under this work insurance. Furthermore, other workers such as agricultural workers, workers covered by other policies, or certain domestic employees may also not be covered. Often this can be the most frustrating reason for denial because there isn’t much you can do about it.

Neglected to Give Notice of a Work Injury

If you were hurt at work, you don’t just want to try and walk it off and hope it gets better. You will want to report it to your supervisor preferably as soon as it happens. While Minnesota has a deadline of 180 days after the accident or you learn of the injury, if you don’t report the accident it will heavily hurt your case. Not reporting the accident can make it difficult to prove that you were even hurt at work. Furthermore, if you did report the accident, but failed to file a claim until after the 180 days have elapsed, it is grounds for denial. The time limit seems like a long time, but it can fly by in a flash.

Injury Was Determined Not to Be Caused By Work

Some injuries can be straightforward in their cause. For example, if you fall off a ladder at work and break your arm, then that is a pretty straightforward case for worker’s compensation. However, if you have a heart attack at work, it could be because of your physically demanding job, but it could sometimes be argued that it is because of your lifestyle outside of work.

Negligent or Intentional Actions

In order to cut the costs of paying an injured worker, they may deny your claim by saying that your actions were negligent or even intention. A good example of this is if you were injured during work horseplay, which is not covered by worker’s compensation. They may also say an injury was intentionally inflicted to file a fraudulent worker’s compensation claim.

Not Pursuing Medical Treatment

You may claim you have an injury, but if you did not seek medical help for the issue, then there really is no concrete proof that you are actually injured. Furthermore, the longer you wait to seek medical treatment, even if your claim is approved, it is likely the insurance adjusters will argue that your injury is not as serious because you “lived with it” for so long without seeking treatment. It is also worth noting that if the employer requires an independent medical examination, failure to attend that appointment may be grounds for claim denial.

What to Do After a Worker’s Compensation Claim is Denied?

If you have found your worker’s compensation claim being denied for any of the reasons above, you maintain the right to appeal the decision. However, it should be noted that some denials are easier to appeal than other. While you should have a lawyer by your side to represent you even in an approved claim, if your claim has been denied in Minnesota, contact us today to talk over your options with the Law Office of Joshua Borken.