Why Was My Workers’ Compensation Claim Denied?

When an employee is injured on the job in Connecticut, they generally expect to be able to collect workers’ compensation benefits, given that all employers (with very rare exceptions) in the state are required to carry the appropriate coverage. However, not every claim is accepted. Connecticut law lays out several situations in which your workers’ compensation claim can be denied, and what actions you may be able to take to get the denial overturned. That said, time can be of the essence, so the need to act fast is real.

Workers’ compensation benefits are intended to be the exclusive remedy for an injured worker, which means that in most situations, an employee cannot file suit against their employer over a work injury – in theory, there is no need because your bills will be paid by your employer. However, if your claim is denied, that means no benefits are forthcoming, which can lead to serious financial and emotional problems.

Reasons for denial tend to fall into two categories – factors that can be laid at your door, and factors that lie with the employer. For example, if your employer believes that your injury did not occur on the job, they may deny your claim; if your claim is denied because you did not yet seek medical help, that is an oversight you made, that you can usually remedy. Other common reasons for a workers’ compensation claim to be denied include:

• You Notifying Your Employer Too Late: Connecticut law requires that an employee who is injured at work must report the injury to their employer as quickly as possible, so that they can notify their insurer;
• You Filing Suit Too Late: You must comply with the statute of limitations. In Connecticut, the statute of limitations for a workers’ comp claim is one year from the date of the incident for a specific injury, three years from the date of the onset for an occupational disease or illness, and one year from the last date of injurious exposure in a repetitive trauma case.
• Not Seeing a Doctor: Failing to seek medical help or failing to seek help from the provider specified by your employer;
• Paperwork Errors: You or your employer make mistakes on the paperwork to submit to the state; and
• Disputes About Cause of Injury/Illness: Your employer does not believe that there is a causal link between your injury and your work.

It can be overwhelming and frightening if your claim is denied, but the most important thing to remember is that in most situations, a denial is not the end of the proverbial road. Such a decision can be appealed, though it is generally a good idea to engage an experienced workers’ compensation attorney to help with the process. The first step is to request an ‘informal hearing’ from the relevant authorities, and go from there.

Contact A Connecticut Workers’ Compensation Attorney

Getting a denial of one’s workers’ compensation claim can feel utterly demoralizing, but once you understand the reasons why, you are better positioned in terms of taking action. The Stratford workers’ compensation attorneys at the Morizio Law Firm are experienced in these kinds of cases, and are ready and willing to try and assist you with getting the benefits you deserve. Contact our offices today at 475-338-3505 for a free consultation.

Sources:

portal.ct.gov/DDS/SelfAdvocacySelfDetermination/Self-Determination-Fact-Sheets/Fact-Sheet—Employee-Safety-Workers-Compensation-and-Liability-Insurance
cga.ct.gov/current/pub/chap_568.htm#sec_31-294c