Workplace accidents can be frustrating and even devastating for a worker and their family. From unexpected medical bills to missed work, workers can experience a great deal of financial stress on top of the physical stress of healing from a workplace injury. Ohio workers’ compensation claims are designed to help fairly compensate injured workers for any workplace accidents, but unfortunately, not every workers’ comp claim is approved.
If a workers’ compensation claim is denied, a skilled workers’ compensation lawyer can help you file an appeal to recover the compensation you are entitled to. If you or a loved one has been injured in a work-related accident and been denied workers’ compensation benefits, Cincinnati workers’ compensation lawyer Mark L. Newman can help. His job is to help you understand the filing process and appeal your claim denial. Call us at (513) 533-2009 to schedule a consultation so we can discuss your workers’ compensation claim.
Top Reasons for Workers’ Comp Claim Denial
Injuries sustained on the job can be stressful, but proper financial compensation can help relieve some of that stress. The Ohio Bureau of Workers’ Compensation (BWC) approved 70,007 new workers’ compensation claims in 2022. Unfortunately, not every claim is approved, leaving the injured employee without the financial assistance they deserve.
There are several reasons that an injured worker may be denied workers’ compensation. Some examples include the presence of a pre-existing condition, a lack of proper medical evidence, or failure to report the accident to your employer. Below are some of the most common reasons a workers’ compensation claim is denied.
Missed Deadlines
A workers’ compensation claim will be denied if the injured worker fails to file a claim within the required time frame. Under Ohio law, the statute of limitations for filing a workers’ compensation claim is one year, meaning claims for workplace injuries or diseases must be filed within 1 year of the worker’s injury, death, or occupational disease diagnosis.
Filing Errors
Another reason an injured worker could be denied is if the claim application is completed incorrectly or missing supporting documentation. This can include failing to list your doctors or signing the application.
Injured workers deserve fair compensation, which is why victims of workplace injuries should hire a skilled workers’ compensation attorney to help them file their claims. As an experienced workers’ compensation lawyer, Ohio attorney Mark L. Newman can help you better understand how the workers’ compensation process works and file your claim correctly.
Insufficient Medical Treatment
Another common reason workers’ comp claims are denied is if the injured worker does not seek medical care within a reasonable time after the accident. The claim may also be denied if the medical evidence fails to include a history of injury and a statement casually relating the history of injury to the diagnosis. The payment of medical bills will be denied if treatment after the initial treatment is with a doctor who isn’t certified by the Ohio BWC.
Dispute By Employer
Employers may not want their employees to file for compensation following a work-related injury so that they can cut costs and prevent their insurance company from raising their premiums. Even if a claim is filed, an employee may be denied proper workers’ compensation benefits if their employer disputes the claim. Employers may claim that the accident did not occur on the job or the injury was the result of a pre-existing condition, preventing their employees from receiving compensation for medical bills and lost wages.
Exclusions
An Ohio workers’ compensation claim will be denied if the type of injury is excluded from the definition of an injury under Ohio law. Such exclusions include:
- Psychiatric conditions, unless related to a physical injury or sexual assault;
- An injury caused primarily by the natural deterioration of tissue, an organ, or part of the body;
- The injury was acquired during the voluntary participation of an employer-sponsored recreational activity (if a waiver is signed);
- Injuries were sustained by an employee who works from home, unless specific remote work injury criteria are met;
- Any pre-existing condition unless the pre-existing condition is substantially aggravated by the injury.
It’s also important to note that independent contractors are not insured, and their claim for workers’ compensation may be rejected.
Can I Appeal a Denied Workers’ Compensation Claim?
Yes, if your workers’ compensation claim is denied, you can file an appeal to receive compensation for your injury. The Ohio Industrial Commission offers online workers’ compensation claim resources for those seeking information on the appeals process. Don’t wait: the appeal must be filed within 14 days of the employee receiving their claim decision from the Bureau of Workers’ Compensation.
After an initial claim for workers’ comp has been rejected, a skilled workers’ compensation lawyer can help someone through the appeals process and advocate on their behalf. If you have been the victim of a work-related accident and had your claim denied, Mark L. Newman can help you file your appeal so you can get the workers’ compensation benefits you deserve. Call (513) 533-2009 to schedule an appointment so we can help file your appeal in a timely manner.
Workers’ Comp Claim Denied? Call Cincinnati Workers’ Compensation Attorney Mark L. Newman Today
A workplace injury can be physically, emotionally, and financially devastating. On top of that, being denied compensation for a work-related accident can be an insult to injury. Additionally, the workers’ comp appeals process is not easy and may require medical documentation of the injury or even witness statements of the accident. That’s why seeking legal counsel from a trusted attorney is so important.
Whether you’re looking to file a claim or appeal a claim decision, call the Cincinnati, Ohio, workers’ compensation attorney Mark L. Newman. Mr. Newman can help employees receive workers’ compensation benefits following a workplace injury and help an employee’s family file for death benefits in the unfortunate event of a job fatality. Call (513) 533-2009 or contact us online to schedule an appointment to discuss your case.
