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Workers' compensation is not always a done deal

A workplace injury may bring your world to a crashing halt. Serious injuries may require hospitalization or recuperation at home, resulting in lost time from work and potentially lost wages. Fortunately, workers' compensation insurance covers these expenses so that employees can recover quickly and get back to work.

However, workers' compensation is a complex process, and you may not realize you have to meet certain requirements before your benefits kick in. One of the worst things an injured worker may face is learning that the insurance company has denied his or her workers' compensation coverage.

Common reasons for claim denials

As with any insurance, you must file a claim to get benefits. This begins with notifying your employer of your accident, usually in writing. There is a time limit, however, and if you miss that deadline, your claim is more likely to be unsuccessful. Many workers find that engaging an attorney to help with the claims process from the beginning reduces the likelihood of missing deadlines.

Some other common reasons why workers' compensation insurance may reject your claim include:

  • You receive treatment from your own doctor instead of a physician within the insurance company's network. While you may feel comfortable with your own doctor, the insurance company will likely only deal with its circle of providers.
  • You fail to give your doctor the complete details about your accident or the full scope of your injuries. If symptoms you forget to mention to your doctor become worse as time passes, you will have a difficult time proving they resulted from the workplace incident.
  • You have a pre-existing condition that the incident at work did not cause even though your job may have exacerbated it. You may receive partial compensation, but this is not likely.
  • Your injury occurred at work but was not related to any part of your job. For example, if you stop by the worksite on your day off and fall, breaking your leg, the insurance probably won't cover that injury.

Even if you have met all of the requirements to qualify for your benefits, you may still receive a rejection from the insurance company. If you disagree with the reasons the insurance company gave for their decision to reject your claim, you may wish to seek advice from a Kentucky attorney who has experience dealing with benefits for injured workers. In fact, the rules and requirements of a workers' compensation claim can be confusing, and some find that seeking professional help from the beginning makes the process go more smoothly.

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