Reasons Workers Comp Is Denied
Brian O Sutter
Workers’ Compensation
For professionals in Florida who have worked hard and earned fulltime employment, with benefits, workers compensation is one of those big factors that creates a lot of peace of mind. In a country where one bad accident is capable of wiping out life’s savings through medical treatment alone, knowing that your company “has your back” if you get hurt on the job is a lot more valuable than people might think.But this compensation, more commonly known as “workers comp,” while reassuring, is not something that you can absolutely rely on. As unsettling as it may be to think, getting injured is not a guarantee that workers com-pensation will be allotted to you by your employer. There are different situations and different reasons why workers comp might be denied, and we’ll go into some of the ones you need to watch for now.
You Weren’t Injured At Work
This shouldn’t need to be pointed out, and yet, for many people, this is a common assumption. Workers comp is not a general form of medical insurance that is there for you no matter what. If it’s the weekend, you’re not at work, and you fall down a faulty escalator at a shopping mall while with your family, you were not working, nor were you at a location aside from your usual place of work that required you to do work.
So you should not be in the least surprised if you try to file for workers comp, and your employers deny it. In this situation, they have 100% legal right to give it to you. You should not, in this situation, dispute the denial and go to a workers comp lawyer. The lawyer will immediately tell you that you have no case.
The Injury Was The Result Of Play
People are people, not machines. So it’s natural for a little humor, or even practical joking to occur from time to time. However, if you get into an accident as a result of pranks, practical jokes, or even an argument that degenerates into shoving and rough-housing, that’s a different story. Workers comp is there to help you recover from accidents that occur while working.
If you get injured as a result of activity that is an obvious deviation from work, and is clearly ignoring standard safety practices, such as waving a welder around as a “gun,” and accidentally burning yourself, this isn’t work. In some cases, this may even be regarded as negligence on your part, and if others are injured by the same activity, you may actually be open to a lawsuit yourself.
You Didn’t Seek Treatment
This one is a little bit more of a gray area, but from a contractual point of view, it’s pretty straightforward. For example, while working at a construction site, you fall, and take a bruise to the leg, but otherwise you think you’re fine. You decided to ignore it, because it doesn’t hurt much, and you continue to work. Even after work, you don’t think much of the injury and so don’t bother to get the injury examined by a medical professional.
A few years later, however, you have difficulty moving, and finally get yourself checked out, only to find out that your muscles degenerated due to the injury and neglect, and you need to get treated for this. Because of the fact that you ignored medical treatment after the initial injury, this creates an array of problems. A file for workers comp on an injury needs documented medical evidence. If you don’t have it then try applying later, you’re at a serious disadvantage.
Your Injury Arises From A Pre-Existing Condition
This can be a difficult fight. Legally, if you have a pre-existing condition such as an illness or injury, and that condition worsens, no workers comp is required to be paid out if it can be proven that it is not the job that made the pre-existing condition worse.
Where things become extremely difficult is in proving that you’re filing for workers comp because of your job, specifically, that has worsened the condition. Carpal tunnel syndrome, for example, can afflict many people, since so many of use type on computers extensively. But if your carpal tunnel syndrome worsens, and it’s documented that you have outside hobbies, such as writing and submitting poetry and fiction on evenings and weekends, it can be argued that the carpal tunnel syndrome is the result of your hobby, and not necessarily the job itself.
As with anything in life, different work and injury situations will have different factors to consider. If you’ve been injured at work, but feel that your claim for workers comp is being denied on unfair grounds, you should get professional help. Talk to a workers’ compensation attorney with experience in getting claims, and see whether or not you have a case that can go to court to get your claim honored.