Missouri’s workers’ compensation law was originally supposed to protect employees financially after suffering an injury in the workplace. But recent changes to the law protect employers and their insurance companies from having to pay. After experiencing a workplace accident, the first thing the employee should do is report the accident to their supervisor and file a workers’ compensation claim. This brings us to a pertinent question: Why would your workers’ compensation claim ever be denied?
There are several specific circumstances that can cause a workers’ compensation claim to be denied. Let’s dig into some of the most common reasons work comp claims are denied.
Most people think that if they are injured at work, their work comp claim can’t be denied. Unfortunately, that is no longer true, due to recent changes in the law. Recently, Employers and their work comp insurance companies are denying injuries even though they clearly happened at work—if the “risk source of the injury was not greater than in the employee’s non-employment life.” What does that mean? If what caused the injury wasn’t something specifically due to your job that you don’t also do at home or away from work, they can deny it. So, the way you describe your injury in the very first time you report it is very important!
Also, If the workplace accident occurred either because of or during activities that were inappropriate or unrelated to work tasks, then the workplace injury claim can be denied. Below are a few examples.
- The employee was doing something illegal.
- The employee was “just walking” or “just stepped out of the truck” without anything work-related that made the risk of the injury greater
- The employee was engaged in a social or recreational activity on the job.
- The employee was intoxicated.
- The employee was traveling to or from work.
A workers’ compensation claim can also be denied if the employee was doing something that is against the company’s rules or policies. Other reasons a claim can be denied include as follows.
- The initial report of injury (both oral and written) or the workers’ compensation claim was incomplete or worded wrong. This is where having a workers’ compensation attorney comes in handy! Call us before you give any written or recorded statement!
- The employer may not be required to provide coverage. This can be the case if the employee is considered a contractor, or if the employer has fewer than five employees in which case work comp insurance is not legally required in Missouri.
- The injury is not directly work-related, but could have happened in your free time.
- The employee was intentionally trying to harm themselves or others.
What Can I Do After My Claim Has Been Denied?
What if you feel your workers’ compensation claim was wrongfully denied?
- You can utilize the Dispute Management Unit offered by the Missouri Division of Workers’ Compensation. This is not recommended for injuries which are serious.
- Seek legal assistance, at no up-front cost to you, by calling a good work comp lawyer.
Seeking help from a workers’ compensation attorney is the best way to handle a denied workers’ compensation claim because they know the legal jargon and how to combat all of the reasons the work comp insurance company throws at you to deny your claim or pay you as little as possible in settlement. They are also familiar with the required forms, deadlines, and other requirements needed to appeal the denial.
How Can You Prove Your Workers’ Compensation Claim is Worth A Settlement?
There are a few key elements that need to be proven for your workers’ compensation claim to be accepted—and to later win a settlement. These elements are as follows.
- The workplace accident occurred–in the workplace.
- The workplace accident resulted in a work-related injury.
- The risk of the injury was caused by something related to work, and not just something that could also have happened at home or on the weekends.
So the question still remains – how can these things be proven? Your workers’ compensation lawyer can help you prove your workers’ compensation claim by gathering and presenting evidence such as…
- Description of the workplace accident and the “risk-source” of the accident
- Medical records.
- Time punches.
- Security footage.
- Eye-witness testimony.
- Expert testimony.
- Receipts
- Correspondence.
- Photos of the personal injury.
How Can A Workers’ Compensation Lawyer Help?
In addition to going over your workers’ compensation claim with you and gathering the necessary evidence to prove your claim, your workers’ compensation attorney can help you with a variety of things throughout the legal process, including but not limited to the following.
- Guiding you through the workers’ compensation process.
- Protecting your rights as an employee—and keeping you from losing your job.
- Calculating the financial value of your work injury.
- Handling negotiations for a fair settlement that covers all of your workplace injury related expenses such as prescriptions, medical treatment, lost wages, any scarring, and future injury related expenses.
- Ensuring that the correct legal forms are filled out properly and submitted.
The majority of Missouri employers are legally obligated to have workers’ compensation insurance in order to protect their employees financially from workplace injuries. Don’t hesitate to claim what is rightfully yours after a workplace accident.
If you have suffered an injury on the job, contact The Hines & Wilson Law Firm as soon as possible to schedule your no-cost initial consultation. During your legal consultation, you will receive free legal advice from an experienced and compassionate Columbia workers’ compensation lawyer near you. Help us help you, and we’ll fight for the compensation you deserve!
