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Why was my workers’ compensation claim denied?

| Apr 27, 2016 | Workers' Compensation

Work-related injuries can happen in any workplace across North Carolina. In general, a person who suffers one of these injuries will be able to secure workers’ compensation benefits to help cover the cost of medical treatment and time away from work that may be necessary.

However, these benefits are not guaranteed. You must first file a claim, and then the North Carolina Industrial Commission must approve the claim, which doesn’t always happen. There are many reasons why claims are denied; below are four common examples.

  1. You were not “on the job”: Your employer or the state workers’ compensation commission might argue that your injury is not covered because you were either not working or not on a work site when an injury was suffered.
  2. Your injury did not meet state guidelines: It may be determined that your injury was unrelated to work or that you are ineligible for workers’ compensation insurance based on employment status.
  3. You were engaged in prohibited activity at the time: Injuries suffered when a person is drunk, impaired by a controlled substance or acting in a way deemed negligent or disobedient are not covered.
  4. You did not seek proper treatment: Unless you seek care in a timely manner and from an approved provider, your claim for benefits can be denied. Similarly, if you do not file a claim in time, benefits can be denied.

Thankfully, you have options to appeal a denied workers’ compensation claim in North Carolina. Discussing with an attorney the steps you need to take to do this can help you make informed decisions and avoid costly mistakes.

As noted above, failure to file a claim in the appropriate time is one of the reasons why claims for workers’ compensation are denied initially. Because of this, it is crucial that you act fast to examine your options and take the steps necessary to secure the financial support for which you are eligible.

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