Workers’ Compensation Denials: When Does an Insurance Company Deny Claims?

Most people know what workers’ compensation is for. It is there to help pay for injuries and illnesses that occur due to an employee’s occupation. What happens if you had an injury that became worse through your current work? If you filed a workers’ compensation claim only to have it flat out rejected because of a previous injury, don’t give up. You don’t have to agree to the rejection. In fact, odds are you are still eligible for workers’ compensation, but you may need the help of a workers’ compensation lawyer.

What Common Conditions Company’s Deny?

If you received a denial, you may be trying to figure out why. Even before you file, it’s important to know what conditions the insurance company might refuse to pay for. There are a lot of pre-existing injuries that a workers’ compensation insurance company might use to deny your claim. These injuries may include:

  • Herniated disks
  • Torn ligaments
  • Broken bones
  • Arthritis
  • Old injuries
  • Degenerative disk disease

Now if you do have an injury that was aggravated by your job, you may not be able to file a new claim. However, you may be able to reopen the old case and receive compensation based on that.

How Can You Challenge the Denial?

Insurance companies often look for reasons to deny injury claims. The adjuster is the one who will look through your medical background to find any pre-existing conditions. When you start working on your workers’ compensation case, you need to think about that. You need to file your claim as soon as possible. When you file, you never want to hide your pre-existing condition. If you neglect to include your pre-existing injury or condition, you could wind up being denied simply because you hid it.  Be as detailed as possible when it comes to your claim. When denied, speak with a workers’ compensation lawyer about the denial. He or she will help you to rebuild your case so that you can file an appeal.

When it comes to workers’ compensation, it is there to help pay for any injuries or illnesses that you suffer on the job. When you are injured a second time, you will want to try to put as much distance as you can between your previous injuries and the ones that you are suffering now. With the help of a lawyer, you can do that. Consult with a Newark work accident lawyer today to find out if you can appeal a denial.


Thanks to Rispoli & Borneo, P.C. for their insight into workers compensation and claim denials.