The workers' compensation program is designed to help injured workers get the necessary medical care and financial resources in the event of a job-related accident or illness. While the system is intended to be “no fault,” claims are still denied, and there can be any number of reasons why. 

3 Common Denials for Workers' Comp Claims

1. Deadlines Were Missed

There are both reporting and filing deadlines in place, and failing to meet these will likely result in a denial from the workers' compensation board. An applicant must first file an accident report with their employer within 30 days of the date of injury. Different states have different deadlines regarding how long you have to file a workers' comp claim before you forfeit the right to compensation; in North Carolina, claimants are given two years from the date of the injury.

2. Sufficient Medical Care Was Not Obtained

In most cases of work-related accidents, the injured party is required to see a doctor who has been approved by the workers' comp board. You are also free, of course, to visit your own physician as well, but failing to receive primary care for the injury from an approved workers' comp doctor can lead to a denial of an injury claim. Always consult your employer immediately after a work accident to find out where to go to obtain care from the nearest authorized medical professional.

3. An Accident Report & Medical Record Have Diverging Information

A denied claim is common in cases where an accident report tells a story that doesn't match with the injuries described in the claimant's medical record. In other words, if what you've reported to your employer and doctor are two different stories, the authenticity of the entire claim will be thrown into question. What is detailed in one's medical records should be the logical result of what follows the injury, as detailed in the accident report.

If you are pursuing a workers' compensation case or dealing with a denied claim, let the work and personal injury lawyers at Hill & Hovis help. They represent the High Point, NC, area in injury, wrongful death, and Social Security disability law cases. Call (336) 883-6000 to schedule an appointment today, or visit their website to learn more about their practice areas.