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Five ways a workers’ compensation claim can get denied

On Behalf of | Sep 23, 2016 | Workers' Compensation |

Missed days of work, pain filled nights, and a short paycheck can be life altering. The last thing an injured employee wants to hear is that their workers’ compensation claim was denied. Anyone in a dangerous job should keep these steps in mind in order to ensure that their claim will be approved.

1. The claim was filed too late

In Colorado an injured worker must report an injury in writing to their employer within four days. Some employers will be more flexible than others, but if the injured worker does not report the injury within four days then they can be penalized. It is possible to lose one day’s compensation for each day the report is late or lose the claim all together if it is very late.

2. The accident statement is inconsistent with hospital records

Workers’ compensation can get denied if the injured employee’s statement about the accident does not line up with the hospital records. If the doctor wrote down that the accident happened a certain way and the employee has a different story then that is an easy way to get a claim denied. It is important to be accurate and consistent with the delivery.

3. The employee was injured without a witness

An injury without a witness is typically scrutinized by insurance companies. Many times a claim can be denied because there was no one else to back up the story. It is still important to report the injury either way.

4. Hospital records show drugs in the employee’s system

If the worker’s hospital records show illegal drugs in their system then the insurance company will likely deny their claim. Although the odds are low it is possible to make a case stronger with the help of an attorney.

5. The employee refuses to give a statement

Insurance companies often ask for a recorded statement of the accident from an injured employee. Employees are not required to give statements but refusing to give one can still hurt their case. It is best to have an attorney present to provide a refined and consistent statement to the insurance company.

Keep in mind that these are general rules and each workers’ compensation case is considered individually. If you have been injured in a workplace accident then first report the injury to your employer and then contact an experienced attorney.


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