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Why would a workers’ comp claim be denied?

On Behalf of | Jul 12, 2021 | Workers' Compensation |

On Behalf of | Jul 12, 2021 | Workers' Compensation

Since Oklahoma provides a “no-fault” system for workers’ compensation claims, persons injured on the job may expect their claims to sail through. That is not always how things work out, and a claimant may find a denial letter arriving in the mail. Several reasons exist why a claim may be denied, but the initial denial may not be the final word on the matter.

Typical reasons why workers’ comp claims are denied

Sometimes, employees file their workers’ compensation claims too late. Instead of reporting their injuries to their employers right away, they wait. Injured employees may put off seeking medical attention, which could also potentially hurt their cause. Generally, injured workers must move swiftly when hurt or face potential hurdles. Regrettably, filing for workers’ comp remains time-sensitive even when someone sustains a severe injury.

Insufficient evidence may factor into a claim denial. Sometimes, medical records or other supporting details prove lacking. A claimant may attempt to compile evidence by him or herself, and a lack of experience leads to an incomplete application.

The claimant’s behavior could factor into a denial. Being under the influence of alcohol or drugs may undermine a claim. Exaggerating or lying about one’s injuries may lead to more than a denied workers’ compensation claim. The claimant may also face legal troubles.

Dealing with the denial

Filing an appeal remains an option for those shocked by an initial denial. The appeal could address problems with the denial, such as false reports that the claimant was under the influence. The appeal may address insufficient evidence denials by providing additional and complete information. Be mindful that appeals must follow a formal process.

An attorney could work with a client who is frustrated about a workers’ comp denial. A lawyer may represent the client and handle the appeal steps.