Workers’ compensation is meant to provide employees with medical and financial benefits if they suffer an injury or illness on the job. However, just like any other type of insurance, workers’ comp claims can be denied.
If you experience an injury or illness as a direct result of your work, learning the common reasons for workers’ comp denials can help you avoid them and—hopefully—receive your benefits as soon as possible.
Failure to report the injury on time
In Maryland, you or your employer must file a claim with the Workers’ Compensation Commission within 60 days of the injury or diagnosis of an occupational disease. Not doing so may risk the insurance company doubting the validity of your claim, which can lead to a denial.
Presence of a preexisting condition
Workers’ compensation may cover a preexisting condition worsened by your work activities. For example, if you already have a respiratory illness and your job made it worse, you can still qualify for benefits.
However, you must show that your job either caused a new injury or aggravated a preexisting condition. Lack of proof can lead to a denial, which is why you must collect as much evidence as you can. This might include medical records, doctor’s evaluations and expert testimonies.
Not seeking medical treatment on time
Prompt medical treatment helps document the seriousness of the injury. If you delay seeking medical attention, it may raise doubts about the severity or validity of the injury. Insurers might argue that the injury was not serious enough to need immediate care.
Plus, you will need medical records as evidence for your workers’ comp claim. They will typically include:
- Details about the injury
- Treatment plans
- Healthcare provider’s opinion on whether the injury is work-related
Without early treatment, there may be insufficient documentation to support your claim.
Workers’ compensation coverage will help you cover medical expenses and maintain financial stability as you recover from your injury. Unfortunately, a denial can delay these benefits or, in the worst-case scenario, leave you without benefits at all.
If you experience any resistance to your claim, working with a workers’ comp attorney can help you fight for the compensation you deserve.