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Potential reasons for denial of your workers’ compensation claim

On Behalf of | Jun 29, 2023 | blog, workers' compensation |

Workers’ compensation aims to protect workers who become injured or sick because of their job. This program offers benefits like wage replacement and medical expenses coverage. However, not all claims made under this system end in approval.

Sometimes, the system denies your workers’ compensation claim, and it is important to understand why that could happen.

Lack of evidence for injury or illness

Your claim might face a denial due to insufficient proof of your work-related injury or illness. Nebraska’s workers’ compensation covers only conditions directly related to your job. If you fail to provide clear evidence linking your condition to your workplace or work activities, your claim might not succeed.

For example, suppose you have a back injury but cannot demonstrate its connection to your job. In that case, the compensation board might deny your claim. Therefore, you must promptly report any workplace injury or illness, seek immediate medical attention and ensure your medical records accurately describe your work-related condition.

Missed reporting and filing deadlines

Nebraska’s workers’ compensation system has strict deadlines for reporting injuries and filing claims. If you do not report your injury or illness within the specified time frame, or if you submit your claim after the deadline, your claim might face a denial.

Always inform your employer about your injury or illness as soon as possible. Nebraska’s Statute of Limitations gives a deadline of two years from the date of the injury or the date when you became aware of your work-related condition to file a claim.

Employer disputes

Sometimes, employers or their insurance companies dispute workers’ compensation claims. They might argue that a non-work-related event caused the injury, or a pre-existing condition, not a workplace incident, is the root of the problem. In such situations, the system might deny the claim until resolution of the dispute.

Understanding these common issues can help you more effectively navigate the workers’ compensation process and secure the benefits you need.