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Why would an employer deny the workers compensation claim?

In order to get the workers compensation insurance, employer has to pay workers compensation premiums to the insurance company. The amount of this premium is directly affected by the number of benefits filed by injured workers. More the benefits filed, more will be the amount of premium that the employer has to pay. So one obvious reason for denying the claim is a simple fie lettered word ‘money’. Workers compensation premium increases when more workers file for the claim or when the company has expensive claims.

Besides money, another factor that leads to the denial of a claim by an employer is the employer bias. The employer simply believes that the injury is not serious or even valid. They believe that the worker filing for the injury is deceiving the organization for financial gains as the injury is not completely true. This happens especially in case of cumulative trauma injuries.

Common reasons given for denying a claim are:

Most commonly the claims are denied on the following grounds:

  • The claimant did not suffer from a serious injury.
  • The injury took place outside the scope of work.
  • The injury does not require any medical aid.
  • The worker does not need time off.

How to fight against a denial benefit?

In case your claim has been denied, you should write to your employer’s workers compensation insurance company. If the problem still prevails, hire a workers’ comp lawyer and request a hearing with the state workers’ comp board. The worker has given up the right to sue the employer in exchange for the workers’ comp benefits and should not feel guilty about using them.

Professionals at Lyle B. Masnikoff and Associates, P.A will fight to get you the medical or wage benefits you are entitled to under the law. Employers and Insurance Companies have professionals working for them and there are no fees or costs until you recover. It‘s time for you to hire us to protect your rights.


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