A workers compensation lawyer in Salt Lake City sits behind his desk doing paperwork.

You work hard at your job, and you expect that worker’s compensation will cover your medical bills and lost income if you suffer an on-the-job injury. This no-fault system is supposed to make it easy for injured workers to get medical care for their injuries and recover some of their lost wages when they can’t work. However, there are still a number of reasons the employer’s insurance company can use to deny your claim. If you need help filing a claim or fighting a claim denial, the next step you should take is to speak with a worker’s compensation lawyer.

How Can a Salt Lake City Worker’s Compensation Attorney Help with Your Claim?

A worker’s compensation attorney is deeply knowledgeable about the many possible difficulties you may experience in trying to access your worker’s compensation benefits. We can assist you in several ways:

We will thoroughly assess your worker’s compensation claim, ensuring everything is meticulously prepared to maximize your chances of a swift approval. Because we understand that many claims are denied due to seemingly minor errors or omissions in the paperwork or tardy submissions, we can help you avoid these issues.

Should your claim be rejected for other reasons, we stand ready to assist you in collecting additional evidence and navigating the appeals process. Our investigative team will conduct a comprehensive evaluation of the circumstances surrounding your accident to determine whether a third-party claim could be possible. 

While worker’s compensation regulations usually preclude injured employees from suing their employers, there are some instances where a third party’s negligence might have played a role in your accident. In such cases, you could have grounds to seek damages beyond what worker’s compensation covers by suing the third party. For instance, if a defective appliance at your office caused your injury, we could potentially pursue a claim against the appliance manufacturer in some situations.

Rest assured that we are committed to exploring every avenue to ensure you receive the rightful compensation and support you need during this challenging time.

What Are Some Common Reasons Worker’s Compensation Claims Are Denied?

The reasons for claim denials vary based on the situation, but in many cases, the employer or their insurance carrier simply doesn’t believe the employee’s account of what happened. It can be frustrating to learn that your employer doesn’t believe you after you were injured at work, but arguing with them or the insurance carrier is not likely to be beneficial. Instead, please contact a worker’s compensation lawyer to learn how we can help you build a case for your claim.

Here are some common reasons that we see in claim denials:

The Insurance Company is Skeptical About Your Injury

Despite the fact that worker’s comp benefits only cover medical expenses and two-thirds of your usual income in most cases, insurance company adjusters are convinced that people frequently fake injuries to obtain these limited benefits. To reduce these concerns, it’s important that you promptly report any injury and seek immediate medical attention. Even if you have verbally told your supervisor or HR representative about the accident, be sure to report it again in a traceable way, such as an email or text message, in case your supervisor “forgets.” Use your personal email or phone so you can keep a record of your report.

Unfortunately, there are instances where, despite the injured person following all the correct procedures, the insurance company adjuster still has doubts. This often happens with soft tissue injuries or conditions diagnosed primarily based on the patient’s reported symptoms. In such situations, your attorney can play a vital role in helping you appeal the rejection. They will thoroughly analyze your medical records and consult with relevant experts to build a strong case on your behalf.

The Insurance Company Accepts That You Were Hurt But Believes the Injury Happened Elsewhere

If your medical records are clear about your injury, the adjuster or employer can still claim that you are lying because your injury didn’t happen at work. For example, you might be told that your Carpal Tunnel Syndrome isn’t from clicking a mouse eight hours a day at work but is actually caused by playing video games at home. Or, the insurance company may think your back pain is caused by lifting too much weight at the gym instead of carrying bags of cement all day on the job. Some people tell us their injuries were blamed on activities they don’t even do in their spare time!

If this happens, your Salt Lake City personal injury lawyer will help you gather evidence to prove your injury happened at work or because of work and not due to activities in your personal time.

Your Employer Claims Your Injury Happened Off the Clock

With electronic time management systems, it’s usually not difficult to prove when someone was or wasn’t on the clock. However, the employer may claim that an injury happened during your lunch break or before you clocked in. In some situations, the employee was technically on their lunch break and clocked out – but they were still doing work activities, such as running a work errand on their way to buy a sandwich. If we can prove you were asked to perform work off the clock, we may be able to appeal your claim.

The Insurance Company Believes Your Injuries Were Self-Inflicted

Insurance companies can’t deny your claim merely because you were at fault or made a mistake that caused your injuries. However, they can deny the claim if they believe you intentionally caused your own injuries. Sometimes it may be challenging to differentiate between an accident and an intentional act in these cases, but your lawyer will do everything they can to demonstrate that what really happened was an accident.

Similarly, the insurance company can deny a claim because the worker was intoxicated at the time or was engaging in horseplay when they got hurt. Again, we will work to prove this wasn’t the case.

The Insurance Company Thinks Your Injury Is Actually a Preexisting Condition

The problem is that a person with a preexisting condition may be more likely to suffer an injury in this area. For example, if you have a bad knee, injuring your leg can aggravate it. If you already have disk disease in your back, you may be more prone to suffering a ruptured disk if forced to lift heavy objects at work. But these predispositions don’t negate the fact that you were injured at work and deserve worker’s compensation benefits. Your attorney will work to show that you were injured at work and your injuries are separate from your preexisting condition.

How to Gather Evidence of Your Injuries

Write down the names and contact info of anyone who was present when your accident happened, then contact a worker’s compensation lawyer immediately. The sooner we start investigating your case, the more likely we are to find evidence that can help you. We will look for the following:

  • Witness testimony. We’ll interview the witnesses to find out their impressions of what happened.
  • Video evidence. We’ll search for nearby cameras and any video evidence that could still be around. Keep in mind that videos are often deleted after a few days due to taking up space on the hard drive.
  • Documents. Sometimes we may request documents detailing problems with equipment or other issues that could have contributed to your accident. Again, we don’t have to prove the employer was at fault, but these can be useful if they claim you faked your injury or it didn’t happen at work.

What If You Are An Independent Contractor?

Independent contractors are not covered by worker’s compensation, but a lawyer may still be able to help you. First, we will discuss your work for the company to make sure you meet all the criteria for being an independent contractor. In some cases, we find that the injured person has been doing the work of an employee without any of the benefits. When this happens, we can take action to address this misclassification, so the worker can get worker’s compensation as well as back benefits like health insurance.

If you are an independent contractor, we will study the details of your accident or injury to determine if you have grounds for a lawsuit or insurance claim. If there is evidence of negligence that led to your injury, we may be able to pursue compensation outside of the worker’s compensation system.

Get Help From a Salt Lake City Worker’s Compensation Law Firm Today

Dealing with a workplace injury and trying to get help from the worker’s compensation system can be frustrating, and many people receive denials for valid claims. If you or a loved one have been hurt at work, please contact Valley Law Accident and Injury Lawyers for a free consultation. We’ll review your case, answer your questions, and explain the options for filing a claim, appealing a denial, or, in some cases, filing a third-party claim. Your initial consultation is free, and there is no obligation, so please call 801-810-9999 today to learn more.

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We have helped many clients recover from injuries resulting from car accidents in West Valley, Salt Lake City, and the greater Utah area. We are here to help you recover after an accident. If you've been injured, don't hesitate to call Valley Law Accident and Injury Lawyers for a free consultation. We have recovered millions for our clients and we are ready to fight for you.

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