Common Reasons for a Workers’ Compensation Claim Denial

Nov 30, 2020 - Workers' Compensation/Work Injury by Cross & Smith

Let an Experienced Tuscaloosa Workers’ Compensation Attorney Help

Workplace injuries are common.  In Alabama, employees who suffer workplace injuries may be entitled to workers’ compensation, which can cover their health expenses, but workers’ compensation claims are often denied — that can put the employee in a financially and emotionally vulnerable situation.

If you would like to get in touch with an experienced Tuscaloosa workers’ compensation attorney, we encourage you to contact Cross & Smith to schedule a free consultation regarding your case.  Call us at 877-791-0618 or send us a message online today.

Here at Cross & Smith, our team has decades of experience working with personal injury claimants, including those who have been injured in a work setting.  We understand how best to navigate the challenges of a workers’ compensation-related dispute, and what is necessary to secure the maximum compensation for our clients (under the circumstances).

For now, let’s take a brief look at some of the common reasons behind a workers’ compensation claim denial.  It’s worth noting that if your claim is denied, you may be entitled to challenge the adverse decision and potentially sue to recover benefits.

Failure to Notify Employer in a Timely Manner

In Alabama, notice of the accident and injury must be given to the employer within five days of its occurrence.  This is a rather short time period, so it’s important not to delay before getting in contact with a Tuscaloosa workers’ compensation attorney who can manage the procedural requirements in a timely manner.

Failure to provide notice before the legal deadline will result in the employee’s claim likely being denied.

Injury Did Not Occur Within Course of Employment

Alabama workers’ compensation laws require that the accident must have arisen out of the course of employment.  In other words, the employee must have been engaged in the duties associated with their employment at the time, and there must be a link between their employment duties and the accident at-issue.

For example, suppose that a construction worker is tasked with moving cement blocks at their employer’s work site.  If they sustain a back injury while moving the cement blocks, that would almost certainly be considered within the “course of employment.”

Condition Not Linked to Workplace Incident

Employees who have a pre-existing condition may find that their workers’ compensation benefits are denied.  These employees will have to show that the pre-existing condition is “distinct” from the injury suffered due to the workplace accident.  Only by establishing that these injuries are separate and distinct can workers’ compensation benefits be obtained.

Employee Misconduct

Employees who engage in misconduct leading to their injury will have their workers’ compensation claim denied.  For example, if an employee is intoxicated at work, and trips and falls off a platform, resulting in injuries, then their workers’ compensation claim will almost certainly be denied on the basis that their misconduct played a contributory role.

Contact Our Tuscaloosa Workers’ Compensation Attorney to Discuss Your Options

If your workers’ comp claim has been denied, help is available. Call our Tuscaloosa workers’ compensation attorney at 877-791-0618 or send us a message online as soon as possible to learn more about your options under the law.