5 Reasons A Workers’ Comp Claim Is Denied: Here Is What To Know

Michigan lawyer discusses 5 reasons why workers’ comp claim denied.

5 Reasons A Workers’ Comp Claim Is Denied: Here Is What To Know

Our attorneys have over 75 years of combined experience representing disabled employees. We have seen all kinds of dumb excuses from employers and insurance companies who refuse to pay workers’ comp benefits. Here are the top 5 reasons workers’ comp claim is denied.

Please remember that every workers’ comp claim is unique, and it is best to speak with an experienced attorney about your own situation. We offer free telephone advice and never charge a fee unless successful with your case.

1. Late reporting of the injury

Employers go nuts when a workplace accident is reported late. They assume everyone is lying and it must have happened off hours. These workers’ comp claims are frequently disputed. Our experience shows that most people do not realize how bad they are hurt until a couple days later. Michigan law requires notice within 90 days and claim to be made within 2 years. Waiting a couple days should not be part of the reasons a workers’ comp claim is denied.

2. The so called “independent” medical examination

Individuals who claim workers’ comp benefits are often required to undergo a medical examination by a doctor selected by the insurance company. These so called “independent” medical examinations are typically used for the purpose of a cut-off. Insurance companies use the same doctors over and over because they know what to expect. Some of these IME doctors make careers out of testifying against disabled people and earn millions of dollars in the process. We recommend speaking with a lawyer if an IME has been scheduled.

3. Refusing light duty work

Michigan law gives employers a powerful incentive to bring disabled employees back to work. They do not have to pay lost wages if they offer a job within restrictions. The problem is that bad employers play games with restrictions and try to get people to walk off the job. This is one of the top reasons a workers’ comp claim is denied.

4. Preexisting medical conditions

Insurance companies think of arthritis as a magic bullet that can be used as one of the main reasons a workers’ comp claim is denied. It is common to see a preexisting condition that has not required treatment be blamed for all current problems. Just because an employee has a preexisting condition does not mean that his or her work injury is not legitimate.

5. Post-injury wage earning capacity

Watch out for insurance companies who use post-injury wage earning capacity (PIWEC) to reduce the comp rate. This happens when a person is considered “partially disabled” and able to find other work. Insurance companies hire vocational counselors to perform a transferable skills analysis and labor market survey. Our experience shows that insurance companies abuse this process and unfairly reduce wage loss benefits. Never accept a reduced comp rate based upon “phantom wages” from a job that might not even available.

Michigan Workers Comp Lawyers never charges a fee to evaluate a potential case. Our law firm has represented injured and disabled workers exclusively for more than 35 years. Call (844) 201-9497 for a free consultation today.

Related information:

IME Disagrees With My Doctor: Here Is What To Know

5 Reasons A Workers’ Comp Claim Is Denied: Here Is What To Know
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