Reasons for Workman's Comp to Deny Me Weekly Benefits
- Common reasons for denying a claim include the lack of an employer-employee relationship. Not every employer is required to carry workers' compensation insurance. Coverage generally depends on the number of employees working for a particular employee. Workers' compensation generally does not apply to independent contractors hired by a client. If an employer-employee relationship is not present, or if the employer is not required to carry workers' compensation insurance, the injured person's claim can be denied.
- In reviewing a workers' compensation claim, fault generally does not apply, but certain situations make the injury noncompensable. This means that if the employee accidentally caused her injury, she still may be able to receive benefits. However, a claim may be denied if the employee was drunk or under the influence of drugs or alcohol at the time of the injury. An employee cannot intentionally injure herself in order to receive benefits.
- The injury must occur on the job or otherwise "arise" out of the employment. Classic examples demonstrating injuries that do not arise out of the employment involve "recreational" trips or deviations from an employee's job duties. An employee driving to a business meeting may be able to claim workers' compensation if injured en route; however, if the employee deviated from going to the business meeting to attend some personal matter, the claim may be denied. Additionally, claims can be denied if the injury occurred while the employee was in an area where he was not allowed to be.
- Workers' compensation claims often turn on the specific facts and circumstances of the injury and the particular job. State laws vary in terms of the procedure workers must follow to file a claim, and claims may be denied for failing to follow those specific rules. Because of the legal nature of workers' compensation claims, injured employees should seek legal counsel before proceeding on their own.