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Why Did My Employer Deny My Workers' Compensation Claim?

If you suffered a workplace injury and your claim was denied by your employer, you are likely stressed out and trying to decide how to cover the costs of your medical bills and missed time from work. However, you have the right to challenge a denial through the workers’ compensation appeals process. Make sure you understand the reasons why your employer denied your claim to begin with.

Your employer or their insurance company must state, in writing, why your claim was denied. Below are some of the most common reasons that are cited for a denial:

  • You did not suffer a serious injury or illness
  • You did not sustain your injury in your place of work or in a work-related context
  • Your injury did not require medical care
  • Your injury will not result in you missing time from work

That said, keep in mind that just because your employer or their insurer states any of the above reasons for a denial of your claim does not mean it is true. This is where the skilled legal assistance of an attorney can immensely help your case. He or she will be able to present evidence to the contrary to ensure you receive the benefits you deserve.

Reasons Why Employers Wrongfully Deny Workers’ Compensation Claims

One of the primary reasons why an employer might wrongfully deny a workers’ compensation claim boils down to the issue of money. Much like your insurance premiums go up when you are at fault for an accident, your employer’s workers’ compensation insurance premium increases based on certain claims. In fact, it is not uncommon for an employer to hire investigators to monitor the actions of an injured worker to try to uncover evidence that your claim is not valid.

Second, employers might deny a claim simply based on their own bias against certain medical conditions, such as repetitive stress injuries like carpal tunnel syndrome. Employers are commonly skeptical of such conditions given that there are often no concrete ways to medically prove them or determine their exact cause. This is particularly true for conditions and injuries that lead to chronic pain.

Lastly, an employer might believe that you do have a legitimate claim, but might still deny it due to bias against the specific employee. Any denial that is based on a bias against a certain race, color, national origin, religion, age, sex, pregnancy, marital status, sexual orientation, or gender identity are all forms of unlawful employment discrimination.

Workers’ Compensation Attorneys in Sacramento

If your workers’ compensation claim was denied and you believe it was denied wrongfully, you need a skilled attorney to handle the appeals process for your case. At Smolich and Smolich in Sacramento, our workers’ compensation attorneys have the experience and knowledge to help you navigate your case no matter what stage you are at in the process. You can rely on our team to guide you toward the favorable resolution you deserve.

Get started today and contact our law office at (916) 571-0400 to request your free initial case evaluation with one of our workers’ compensation attorneys. You will not owe us any legal fees unless we are able to win your case.

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