3 common reasons for workers’ comp claim denial

On Behalf of | Oct 26, 2021 | Workers Compensation, Workers' Compensation |

If you have experienced a serious job-related injury, your employer’s workers’ compensation insurance policy may help cover medical expenses and a portion of your lost earnings. In North Carolina, the law requires that most companies provide this type of insurance coverage for workers.

Unfortunately, insurance companies often try to deny claims to avoid paying for benefits. If you fail to meet certain deadlines or provide enough documentation, you may find your claim rejected, even if you have a valid case.

1. You did not report your injury in time

In North Carolina, you must report an injury to your employer, verbally and in writing, within 30 days of the incident to remain eligible for workers’ compensation. Even if an injury initially seems minor, you should notify your supervisor as soon as possible.

2. Your injury was not work-related

Reporting an injury quickly is also important for proving to the insurance company that your medical condition is work-related. If you wait to report, the insurer may argue that your injury did not happen on the job.

3. Your injury does not require serious medical treatment

The insurance provider may deny or undervalue your claim by insisting that your injury does not prevent you from returning to work or is not as severe as you say. When applying for benefits, it is important to provide all medical documentation related to your injury, including test results, medical records and doctors’ notes or statements.

If you believe an insurer has wrongly denied your claim, you may appeal the decision by requesting a hearing with the North Carolina Industrial Commission. With better preparation and documentation, you may be able to receive the benefits you need.

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