Can Your Employer Deny Your Benefits? What You Need To Know

Worker's compensation insurance exists to help employees who are injured while doing his or her job to cover lost wages and medical costs. Unfortunately, not all employees will receive approval. Here are some examples of why a worker's compensation claim is not approved:

You Were Not Working When You Were Hurt

There can be confusion when it comes to what qualifies as a work injury. To get worker's compensation, you have to have been hurt while you were on the job doing a task within the scope of your employment. The only time when you do not have to physically be on your employer's property is if you are doing a job while at a different location, such as while you are on a sales call. If you were on the clock, not on a break of any kind, and considered working at the time of your injury, you can qualify. If you were not actively working when you suffered your injury, such as while commuting to and from work or doing errands during a break.

You Did Not File in Time

Worker's compensation claims have to be submitted within a timely manner to your human resources department. You have to submit a First Report of Injury within a specific time frame based on the requirements of your state. If you miss the deadline by your state's deadline, you could miss out on receiving worker's compensation benefits.

You Did Not Use the Prescribed Doctor for Your Treatment

When you are hurt and file a worker's compensation claim, you must go to the physician provided by your employer. This is done for several reasons. Some employers have existing, ongoing relationships with certain doctors and they know how their claims process works. They also want you to see an unbiased physician. If you choose to go to your own doctor instead, you may not get your worker's compensation benefits. You can request to see your doctor, but your employer will likely not allow it. What you can do, however, is see your own doctor in addition to your employer's physician if you wish to have a second opinion. Keep in mind, however, that you will not be paid for your own doctor's appointment.

You must follow all the worker's compensation rules set forth by your state in order to receive your benefits. Be sure to contact your attorney if you believe you are being denied your benefits unlawfully.

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