Each year, more than 2.3 million workers worldwide have a work-related injury. The healthcare expenses and other costs associated with certain injuries are covered by workers' compensation insurance in the US. Knowing the potential reasons your VT workers' compensation claim can be rejected will be helpful if you intend to submit this kind of claim.
Most of us anticipate that our employers' workers' compensation insurance will pay for medical expenses and time off work if we are hurt at work. Most of the time, this is true. In many jurisdictions, including Vermont, workers' compensation is a no-fault system, meaning that any employee harmed during a working accident will receive benefits regardless of who caused it. Every employee in Vermont has a right to a secure workplace. In Vermont, workers' compensation benefits will pay for both your medical expenses and lost wages if you suffer an occupational injury.
When legitimate claims are rejected, your employer and the insurance companies both save money. The insurance company wins because they don't have to pay you any benefits, and your employer wins because their insurance costs won't increase if a claim is denied.
Independent contractors are not protected by Vermont's no-fault workers' compensation system; however, you should get in touch with a skilled Vermont workers' compensation lawyer right away if you were hurt at work and think you were wrongly classified as an independent contractor.
It depends on your exact injuries and the circumstances of the accident to determine whether you are entitled to bring a personal injury lawsuit to obtain compensation outside of workers' compensation. However, if someone is injured on the job, files a workers' compensation claim, and receives benefits, they usually cannot sue their employer in a separate personal injury lawsuit for the same claim.
Particularly if you've suffered a serious injury or have been left permanently disabled, it's crucial to seek legal guidance from a knowledgeable Vermont workers' compensation attorney. The skilled Vermont workers' compensation attorneys at Brandon J. Broderick, Attorney at Law, are dedicated to assisting clients in achieving the best outcomes.
Reasons For Denying Your VT Workers’ Compensation Claim
According to our experience, insurance companies typically provide the following explanations for denying a workers' compensation claim:
Your Accident Wasn't Related to Your Job
One of the simplest grounds for the insurance company to reject your claim is this. They will do so if they can demonstrate that your ailment is unrelated to your job because doing so allows them to reject the claim.
Examples of what we have observed include:
- There is no evidence that your accident occurred at work because no one saw it happen.
- Your injury was brought on by a pastime or activity you engaged in outside of work.
- The injury was brought on by a pre-existing condition you have.
- You failed to inform your employer of your injuries when it occurred.
These are a few of the most typical "workarounds" insurance companies use to dispute a claimant's assertion that it was related to their place of employment. Get in touch with Brandon J. Broderick right away if your claim has been rejected for one of these reasons. We would adore the chance to show you how we can assist by having you come in for a free case evaluation.
You Did Not Inform Your Employer Promptly
Notifying your employer of your accident immediately after it occurs is crucial for strengthening your workers' compensation claim. Several such outcomes are possible if you wait:
- Your employer or their insurance company may attempt to argue that you were not truly injured on the job since you would have reported it sooner if you were.
- The insurance provider may assert that the injury resulted from a pre-existing condition.
Your Medical Records Do Not Support Your Claim of Injury
To build a strong case for workers' compensation, you must provide medical evidence. If you file a workers' compensation claim without supporting medical documentation, the insurance company will have grounds to deny your claim. Therefore, one of the first things you should do after sustaining a workplace injury is to visit a doctor and have your injury documented and treated.
Document ALL of your injuries and symptoms, even if they appear minor or unrelated at the time. Things can often get worse over time or flare up later, but if they are documented in your medical records, it is more difficult for the insurance company to argue they are unrelated or new. Understand that the insurance company may see everything you tell your medical professionals about the injury, so be consistent and thorough.
When Requested, You Did Not Sign Medical Authorization Forms
The insurer assigned to your case will want to review your injury-related medical records and bills. This is vital because it might assist establish a connection between your injury and the workplace.
If requested, you must sign the required authorization (Form 7). If you do not, it gives the insurance company a reason to deny your claim. You do not have to disclose your whole medical file to the insurance in order to maintain your privacy. You will only need to grant them access to your treatment records for work-related injuries. Importantly, the insurer has a legal obligation to examine your claim, therefore you should not suppress relevant information without cause.
A Pre-Existing Condition Was Responsible For the Injury.
This is perhaps one of the most common strategies used by insurance companies to deny claims. They will attempt to argue that the injury you experienced was not new and had existed for a long time prior to the incident. Regardless of your medical history, if a new work injury worsens your underlying condition, you are entitled to benefits.
This is why you will need to retain a competent Vermont workers' compensation attorney. A skilled attorney, such as those at Brandon J. Broderick, will be able to establish the connection between your accident and your workplace in order to help you collect the maximum compensation you deserve. Don't make the same mistake as several others. If your claim was denied on the grounds that a pre-existing condition caused the injury and you are worse off as a result of your workplace injury, you should not accept the denial.
VT Workers' Compensation Lawyers Ready to Help You
Our Vermont workers' compensation attorneys at Brandon J. Broderick, Attorney at Law, are motivated by compassion and dedicated to assisting injured workers in obtaining the maximum amount of eligible workers' compensation payments. We have years of experience and the extensive resources you need to secure a fair case result.
Contact us to schedule a free consultation if your workers' compensation claim has recently been denied after you were injured at work. We are ready to support you at every stage of your case and assist you in obtaining the compensation to which you are rightfully entitled.