What Can You Do If Your Employer Wants To Deny Your Workers' Compensation Claim?

Posted on: 4 October 2021


When you're injured on the job, you expect workers' compensation to cover your injuries and protect your livelihood. In almost every job, the law guarantees this to workers. Unfortunately, your employer may not always want to pay out on claims.

How Does Workers' Compensation Work?

Most employers must carry workers' compensation insurance that covers medical bills and lost wages due to injuries that happen to work. The most important part of understanding workers' compensation is that it is insurance.

Your employer has to pay insurance premiums based on your job and how much you work. Like other insurance products, their insurance premiums can go up if they have a history of filing claims. That means that if they have to pay your worker's compensation claim, there's a good chance they will have to pay more for insurance in the future. That gives them a reason to want to deny your claim.

Who Determines if You Were Injured on the Job?

If you've been injured, you usually have to go see a doctor chosen by your employer or the workers' compensation insurance company. This is a requirement of receiving your benefits. That doctor will then evaluate your injuries including how they happened and whether you're able to return to work.

Since that doctor works for your employer or the insurance company, you may be worried that they'll want to find a reason to deny your claim. Doctors still have to follow medical ethics, but there is a conflict of interest that might cause them to give the benefit of doubt to your employer. Because of this, you also have the right to go to your own doctor for a second opinion.

How Do You Appeal a Workers' Compensation Decision?

Workers' compensation starts like most other insurance claims. You submit your claim then if it's denied, you can submit more information. For example, if you want to your own doctor, you can submit their findings to try to get the insurance company to change their mind.

If you can't get what you're entitled to through the worker's compensation claims process, you have the right to go to court. Remember that your employer has a legal obligation to cover you for workplace injuries. If they or their insurance company don't meet this obligation, that gives you the grounds for a worker's compensation lawsuit.

To learn more about getting your worker's compensation claim honored, talk to a local workers' compensation lawyer today.