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Can your workers’ compensation claim be denied?

by | Dec 27, 2022 | Workers' Compensation

If you sustain an injury or develop an illness as a result of your work, you need to pursue financial restitution through your employer-sponsored workers’ compensation program. These benefits are designed to cover your treatment costs as well as lost earnings among other damages.

To qualify for the benefits, however, you must meet certain requirements. It is important to understand these requirements in order to boost your odds of receiving the compensation you deserve following your work-related injuries:

Qualifying for workers’ compensation benefits in California

To be eligible for workers’ comp benefits, you must meet the following requirements:

  • Your injury or illness must be work-related. This means that you must have sustained the injury while at work or performing an employer-sanctioned errand.
  • You must make your employer aware of the injury or illness and file your claim in time
  • You must not have contributed to the injury. For instance, you must not have violated workplace policy when the injury happened. Your employer can successfully dispute an injury that you sustained while drunk.

Common reasons for workers’ comp claims denial

YES, your workers’ compensation claim can be denied for a variety of reasons. Here are two reasons why this can happen:

If your injury was not work-related

Workers’ comp claims, as the name suggests, are designed to offer financial restitution for injuries or illnesses that are sustained at work or while performing activities that are approved by your employer. Your claim will likely be denied if your injuries were in no way related to your job. These include injuries that you sustain while out of your workplace for a lunch break.

If you miss important deadlines

Under California law, you are required to report any work-related injury within 30 days from the date of the accident. Additionally, you are required to file your workers’ compensation claim within the statute of limitations period. And in California, this is one year from the date of your injury or the discovery of your work-related illness. Missing these crucial deadlines can lead to your claims’ denial.

Knowing your legal options and obligations can help you protect your rights and ensure that you avoid mistakes that can stand in your way while pursuing your workers’ compensation benefits.