Common reasons for denied workers’ compensation claims: Part I

Jan 06 2016

Workers’ compensation is supposed to be a fast and efficient way to resolve claims for injuries suffered on the job. When everything works as designed, injured workers are compensated without the need to sue their employer, and employers don’t spend valuable time and money defending themselves in court.

Unfortunately, the claims process is not always a smooth one, usually to the disadvantage of the injured employee. Claims are sometimes denied, even if they are legitimate. In our next two posts, we’ll discuss some common reasons for claims denials.

Insurance is a bureaucratic industry, and your claim may have been denied because you failed to meet filing deadlines or other requirements. In Colorado, workers who suffer injury on the job are typically required to notify their employer in writing within four working days. Even if you verbally reported the injury, it is important to follow up with a written notification.

The statute of limitations could be another important factor – especially in the case of a work-related illness or injury that developed over time. Insurers may try to deny claims if the statute of limitations has expired. These cases are often more complex, so you may want to consult an attorney about the timeline of events.

Finally, your claim may be denied if you failed to fulfill other necessary requirements such as attending an independent medical examination. If you miss your appointment, your injuries cannot be independently verified and the insurance company may deny the claim.

Check back next week as we continue this discussion. We’ll share some common reasons claims are denied due to disputes about the injuries themselves.