Why would your workers’ compensation claim be denied?

On Behalf of | Dec 7, 2021 | Workers' Compensation

You got hurt at work and your doctor has recommended that you take a couple of days off so you can recover. Time to nurse your injuries while awaiting the arrival of your workers’ comp check, right? Well, this is exactly how things work out for some injured workers. For others, however, the claim ends in a denial. 

The workers’ compensation program exists to provide injured workers with the medical treatment and income they need while recovering from the injuries they sustained while at work. If this is the case, then why would your workers’ compensation claim be denied? 

Here are some of the common reasons for workers’ comp denial.

Your injury did not happen at work

To be eligible for workers’ compensation, your claim must meet these conditions:

  • Your injury arose from your employment in some way or your work was a major contributing factor to your condition.
  • The injury must have happened during the course of your work activities.

Your workers’ compensation claim is likely to be denied if your injury happened outside of work (like while you were out on a lunch break) or if you were running personal errands and 

You delayed reporting your injury

Every state has a timeframe within which you must report any injury sustained in the workplace to your employer. In New Jersey, you only have 14 days from the date of the accident to report your injury and up to two years to file your claim. It is highly likely you’re your claim will be dismissed if you let these important timeframes pass. 

You were involved in illegal activity

Workplace safety is an important component in preventing or reducing workplace-related injuries. If your employer, or their insurance company, establishes that you were doing something illegal while at work, and this resulted in the accident that caused your injury, then it is highly likely your workers’ comp claim will be denied. For instance, if you were operating a dangerous machine or driving while intoxicated, then you may not be compensated for injuries sustained as a result of your actions. 

When you are hurt on the job, you might be tempted to believe your eligibility for a workers’ compensation claim is all but guaranteed. However, this is not always the case. Don’t hesitate to seek experienced assistance if you need it.