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What are common reasons for workers’ compensation denials?

On Behalf of | Feb 9, 2023 | Workers' Compensation

Injuries can happen anywhere in New York and people’s place of employment is no different. If people suffer injuries at work that prevents them from working, it can be very difficult. People may need to incur significant medical bills and also lose income since they are not able to work while recovering. Figuring out how they will be able to pay for their rent or mortgage, utilities, food and other necessities can be difficult.

Many workers who suffer injuries while working can receive workers’ compensation benefits. These pay for a portion of the injured workers income and also can pay for the medical bills associated with treating the injury. This can be very valuable as people recover. That is why it can be very detrimental when employers deny workers’ compensation claims.

Common reasons for workers’ compensation denials

Companies deny these claims for a variety of reasons, but some of the common reasons are:

  • Missing deadlines: Injured workers need to notify their employers of the injury within a reasonable time after the injury occurs. There are also other deadlines for completing certain paperwork and if they are missed, they may be denied.
  • Non–work-related injuries: The injury did not happen as a result of work-related activities or while they are on duty
  • Worker horseplay: The injury was the result of the worker partaking in horseplay or engaging in activities that are not work-related with other co-workers
  • Under the influence of drugs or alcohol: The worker was under the influence of drugs or alcohol when the accident and injury occurs.
  • Did not seek medical treatment: Worker did not seek medical treatment for the injury within a reasonable time after the injury occurs. It may also be denied if the workers uses a medical professional that is not in the company’s network of medical professionals

Workers’ compensation is supposed to be there for workers in New York who are injured while working. However, not all employees receive these benefits when they apply for them. Some of the reasons are valid for denials, but many times, the employers’ reason for the denial is not acceptable under the rules for workers’ compensation benefits. People may be able to appeal initial denials and consulting with experienced attorneys could be beneficial.