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As a general rule of thumb, you should never discuss anything except the basic facts of the accident, including where it occurred, the date and time it occurred, what type of accident it was, and which body parts were injured.
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.
WorkCover may also reject your claim if no one saw what happened; if there are any inconsistencies between your account of what happened (on the initial accident report) and evidence (including medical records); if there is reason to believe you were under the influence of drugs or alcohol at the time of the accident;
Fighting a Denial of Benefits If you receive a notice that your claim has been denied, call or write to your employer's workers' comp insurance carrier. If this doesn't solve the problem, hire a workers' comp lawyer and request a hearing with the state workers' comp board.
The top three leading causes of work-related injuries overexertion and bodily reaction, slips, trips and falls, and contact with objects and equipment account for more than 84% of all nonfatal injuries involving days away from work.
Since many medical conditions are difficult to confirm, claiming an employee is malingering may save the insurance company money by fighting the claim.You have the right workers compensation benefits if you have been injured in the scope of employment and a skilled personal injury lawyer can help you.
Most states allow an employer to dispute or contest a workers' compensation claim, but each state has its own procedures for doing so. Contact your carrier or state to get the detailed information and step-by-step process to dispute a workers' comp claim.
You must provide to your insurance carrier a WRITTEN detailed explanation of why you believe your bill is incorrect. You must provide to your insurance carrier a WRITTEN detailed estimate of what the correct premium should be.
Employer can dispute liability for further workers' compensation payments where there is a 14 (or more) day gap in medical certificates.It was found that employers are able to treat a delayed certificate as a fresh claim for compensation, and dispute liability.