Your employer is legally obligated to provide workers’ compensation insurance for employees who suffer work-related injuries. Your employer will purchase workers’ compensation from a private insurance company to protect you from financial ruin if you are hurt at work.
If your employer denies your claim, it can not only be a nightmare for you and your family trying to fight the decision in court, but it can have a huge financial impact on you. Consider consulting a Fall River workers compensation lawyer to evaluate your case and guide you on the best possible option for you.
Why Your Worker Compensation Claim Was Denied
Massachusetts has its own set of rules that should be adhered to by both employees and employers. If these rules are broken, the insurance company might use that as a reason to deny your claim. Below are some of the reasons your workers’ compensation claim was denied:
1. You’re Not Eligible For Workers’ Compensation
You might be disqualified from workers compensation if you are:
- An independent contrator
- A farmworker
- A seasonal worker
- A domestic worker like a housekeeper or a babysitter
- An undocumented worker
2. You Didn’t Notify Your Employer in Good Time
By law, you are required to report a work-related injury or illness within 7 days after the injury occurred, excluding Sundays and legal holidays. Your employer is also required to report your injury to their insurer within seven days after you submitted your report. Your workers’ compensation claim won’t begin until you report your injury to your employer within the stipulated timelines.
3. You Didn’t File Your Workers’ Compensation Claim
Under Massachusetts law, you must file a workers’ compensation claim within 4 years of the date after you become aware of your work-related injury. Filing for workers’ compensation is not the same as reporting your injury and missing the deadline for filing your claim might result in your claim getting denied.
4. Your Injuries Were Not Work-Related
Your injuries must have happened while you were performing work-related duties. The injuries do not need to have happened at the worksite. There are many instances where injuries occur outside the work environment. For instance, if your employer sent you for a client meeting outside the country and got injured while traveling, you are covered. However, if you decide to have some fun after the client meeting and you get injured in the process, you might not get compensation.
5. You Were Under the Influence of Alcohol and/ or Drugs When You Got Injured
Your claim will automatically be denied if it’s evident that you were under the influence when you got injured. It’s also important to note that your claim might be denied if you were under the influence of prescribed medication. For instance, if it’s discovered that you abuse your prescription medication, not only could your claim be denied, but you could also face legal action for endangering other empoyees.
6. Your Employer Disputed Your Claim
Your employer might claim your injuries were not work-related, you’re faking your injuries, or you had a pre-existing condition. Unfortunately, it’s up to you to prove that your claim is legit and you can do this by hiring a workers compensation lawyer in Fall River, MA. Your lawyer will not only protect your rights as an employee, but they can also calculate how much your claim is worth.
7. You Were Fired
If you file a workers’ compensation claim right after you were fired, the insurance company will claim that you are trying to exact revenge on your former employer. Additionally, if your doctor cleared you to return to work but you haven’t your employer could fire you and your employment injury benefits could stop coming in. The good news is your employer is not legally allowed to fire you for filing a workers’ compensation claim.
How a Fall River Workers’ Compensation Claim Lawyer Can Help Your Case
The most common reason why people get their workers’ compensation claims denied is due to insufficient medical evidence. A Fall River workers compensation lawyer can develop medical evidence by:
- Getting medical experts to testify on your behalf
- Representing you at depositions
- Getting an independent medical examination for you
- Recommending treatment with certain doctors
- Gathering your medical records
At Kevin P Landry Law Offices, we offer free case evaluations. Schedule your free initial consultation with us today at 508-676-0001 and we can discuss your case
