Here To Assist You When The Unthinkable Happens

4 common reasons for a workers’ compensation claim denial

On Behalf of | Sep 11, 2023 | Workers' Compensation

When an employee gets injured on the job in Washington state, workers’ compensation provides them with financial support and covers their medical expenses.

However, not all claims go smoothly. Understanding the common reasons behind workers’ compensation claim denials can help employees navigate the process more effectively.

1. Lack of timely reporting

One primary reason for denial is the failure to report the injury promptly. Employers and insurance companies require injured workers to report incidents within a specified timeframe, often within 24 to 48 hours. Failure to report in a timely manner may raise doubts about the legitimacy of the claim.

2. Insufficient medical documentation

Accurate and thorough medical documentation is necessary when filing a workers’ compensation claim. If medical records do not clearly establish a connection between the injury and the workplace, the claim may not go through.

3. Discrepancies in the incident report

Inconsistent or inaccurate incident reports can also lead to claim denials. Any discrepancies between the initial accident report and subsequent statements may serve as red flags by insurance companies. Employees should ensure that all details are consistent and accurate throughout the claims process.

4. Late filing

Another common reason for denial is missing deadlines for filing a claim. Each state has its own statute of limitations for workers’ compensation claims. In Washington, you have one year to file a claim. Failing to submit a claim within the specified timeframe can result in automatic denial.

If you are one of the 4.9 million workers who file a claim workers’ compensation claim each year, you rely on that support for your recovery. Being aware of these potential pitfalls can make the process smoother and more likely to result in a positive outcome.