Insurance companies deny workers’ compensation claims for a variety of reasons, and injured workers should determine why their claims were denied before they move forward. The Notice of Primary Liability Determination issued by the insurance company should explain, at least briefly, the reasons for a denial. After a worker’s claim is denied, he or she must take steps to contest the claim denial in order to receive benefits, as discussed in a previous blog.
Work Activities Not a Substantial Contributing Factor
One reason insurance companies deny workers’ compensation claims is because they believe that work activities were not a substantial contributing factor to the injury claimed. For example, the employee may have a prior injury or pre-existing condition such that the insurance company thinks the employee already was injured. In this situation, the employee can argue that the work activities aggravated a prior injury.
Alternatively, the insurance company may suggest that the injury occurred outside work. Employees who are injured when they are off the clock, on vacation, or on their way to work may not be covered by the workers’ compensation statutes. Insurers also deny claims because they believe the workers were under the influence of alcohol or illegal drugs when injured.
Injury Does Not Prevent You from Working
To receive workers’ compensation benefits, your injury must be serious enough to prevent you from performing your usual work duties. Paper cuts or small scrapes usually are not serious enough. Of course, employers should take any injury on the job seriously and have a first aid kit handy.
Workers should know, however, that many different types of injuries are compensable. Minnesota law recognizes everything from PTSD to broken bones to back strain as work injuries for which workers can receive benefits.
Failure to Timely Notify Employer
Employees need to notify their employers as soon as possible after they discover a work-related injury. To have the best argument that you timely notified the company, report the injury immediately on the day it happens. If you have a repetitive strain injury or long-term injury, report the injury as soon as you learn you have this condition – such as after you receive a medical diagnosis.
If your workers’ compensation claim was denied, seek legal help to get the benefits you need. Joe Osterbauer, Esq. and the Osterbauer Law Firm stand up for injured Minnesota workers’ rights. Joe’s 27 years of workers’ compensation experience and his team’s speedy service combine to get clients the results they need. To schedule a free consultation, visit Osterbauer Law Firm online or call Joe’s office at (612) 334-3434.