What is the most common reason a workers’ comp claim is denied?

by Andrew Bainbridge | Feb 18, 2015 | Workers' Compensation

As an employee here in Ohio, you are supposed to have access to workers’ compensation benefits when you suffer an injury while at work or develop a work-related illness. This compensation is typically considered incredibly important by those who receive it because it can be used to offset the impact of expensive medical bills and lost income from missing days at work.

But as so many of our more frequent readers know, claims aren’t always approved on the first try. In these cases, claimants must endure the process again by appealing the denied claim. The hope at the end is always the same: that their claim will finally be approved and they can collect the benefits they may need.

If you’re like a lot of our readers, then the topic of a denied claim probably raises an important question in your mind: what is the most common reason a workers’ comp claim is denied? In today’s post, we’ll hopefully be able to answer this question by looking at what the Ohio Bureau of Workers’ compensation has to say about it.

As the BWC explains, the most common reason why claims are denied is because they lack the necessary information to make an appropriate decision. Remember, the BWC only has 28 days to make a decision regarding your case, meaning if some information is missing, they may not have enough time to track down the answers they need in order to make a decision on time.

It’s worth pointing out that missing information can include: specificity of injury or illness and to what extent it has impacted your ability to work, incomplete medical records tracking treatment of the work-related injury or illness, failing to report an injury or illness immediately after identifying it as work-related, or not having a sufficient enough eye-witness account of the accident that caused the injury.

It’s important for you to know that even if your claim is denied on the first try, you do have the right to appeal the decision. Please note though, the complexity of the law can make the appeals process rather difficult to manage without the right legal knowledge. It’s because of this fact that you may want to retain the services of a lawyer who can not only explain the law to you but can help you navigate it effectively as well.

Tags: Workers' Compensation