When Can A Workplace Accident Claim Be Denied?

Accidents can happen anywhere — even at work. In 2019, there were approximately 69,000 nonfatal workplace accidents in New Jersey. Most of these claims are approved without incident.

However, there are situations in which claims can be denied by the employer or the workers’ compensation insurer. This is likely because the case looks fraudulent or there is little proof that the accident did in fact take place in the workplace.

Was your workers’ compensation claim denied? If so, it may have been because of one of these reasons.

The Injury Didn’t Happen at Work

Some people try to file claims for injuries that occurred on their lunch break or during their commute to and from work. Some employees work from home and may claim that the injury happened in their home when it actually happened outside while playing basketball or running. There are two conditions that must be met: the injury must have occurred during the course and scope of your employment and it must also arise out of the employment.

You Waited Too Long

If you are injured at work, tell your employer right away. If you wait too long, it will seem as though you were not injured too badly, which can impact your claim. Plus, under New Jersey law, you only have 14 days to file a workers’ compensation claim, so time is of the essence.

There are Discrepancies

Some people lie about getting injured, so they change their story every time, causing discrepancies to show up in the report. Therefore, make sure to tell the facts and if asked, say the same thing every time. If you keep changing things or add new information each time, the insurer is going to get suspicious.

You Were Intoxicated

Workplace accidents that occur when an employee is drunk or on drugs are not covered. If you file a claim and fail a drug test, your claim will be denied.

The Injuries Were Intentional

If you were required to wear safety devices and you failed to do so and got injured, your claim could be denied or at the very least reduced. The same applies if you injure yourself on purpose to receive compensation. Claims involving horseplay and fighting that result in injuries may also be denied.

There Were No Witnesses

While the fact that there were no witnesses won’t lead to an automatic denial, it will cause your claim to be scrutinized more carefully. That’s because nobody can prove that the accident took place. Your best course of action is to report the accident immediately.

Contact a New Jersey Personal Injury Lawyer Today

It can be frustrating when a workers’ compensation claim is denied, but insurers have good reasons for doing so. That’s why you need to file an accurate and thorough claim.

If you were injured in the workplace, the Morristown work-related accident attorneys at The Law Offices of Michael P. Burakoff can help. We can help you understand all your avenues for compensation. Fill out the online form or call (973) 455-1567 for a free consultation.

Resource:

bls.gov/regions/new-york-new-jersey/news-release/workplaceinjuriesandillnesses_newjersey.htm#:~:text=PDF%20version-,Employer%2DReported%20Workplace%20Injuries%20and%20Illnesses%20in%20New%20Jersey%20%E2%80%94%202019,of%20Labor%20Statistics%20reported%20today