Just like other types of insurance policies, employers have to pay premiums to provide workers' compensation benefits for their employees. The amount that an employer pays their insurer is directly affected by workers’ comp claims that are filed by injured workers. Because of this, employers are not eagerly awaiting for your claim to be approved. In this blog, we explain a few of the common reasons employers dispute workers’ compensation claims filed by their employees.
Cost of Premiums
As discussed above, the more workers' comp claims that are filed, the higher the costs will be for the employer. Workers' comp insurance premiums go up when the number of claims filed exceeds the estimated amount, or when an employee has a particularly expensive claim. For this reason, employers and their insurance companies regularly use investigative agencies to oversee the daily activities of employees who have filed workers' comp claims.
Sadly, many employers refuse to believe that their employee’s injuries are severe or even real. This is particularly true when it comes to cumulative trauma injuries. Employers often assume that an employee who files a workers' comp claim for carpal tunnel syndrome is lying. This bias can be especially strong against injuries with inexplicable pain. Many times these injuries cannot be verified with medical examination or by x-rays and other imaging technology. However, despite the symptoms being difficult to diagnose, this does not mean that the worker is not entitled to workers’ comp benefits.
Common Reasons used by employers to deny workers’ comp benefits include:
- The employee didn’t experience a serious injury
- The employee’s injury didn't take place during work, or within the scope of their employment duties
- The employee did not need medical treatment for their injury
- The employee did not need time off work for their injury
What Should I Do If My Workers’ Comp Claim Is Denied?
If you have been given notice that your claim has been denied, you should call or write to your employer's workers' comp insurance carrier. If this doesn't resolve the issue, you should consult with an experienced workers’ compensation attorney to discuss your legal options.
At the Law Offices of Andrew B. Shin, we understand how frustrating it can be to get your workers’ comp claim approved. This is why we are here to help you complete the necessary paperwork and to guide you through the complex process of filing your claim.
Contact our San Jose team of workers’ compensation attorneys to schedule your free consultation today.