workers comp is denying my claim?
I was injured a few years back then reinjured myself workers comp denied the claim. Hr insists it workers comp. Havent been paid in 5 weeks and Human resources says im covered. Can their insurance still deny me? I hate to sue but im pretty badly injured. What should i do?
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If your company really believes that it is, try and get them to contact their insurance company and see why it is being denied. Otherwise, you may have no choice but to sue them. Its unfortunate, but may be your only way to get what you deserve. I have a former co-worker going through the same thing. I wish you the best of luck, get a good attorney.
It depends on the injury how it happened and so forth. I deal with workers comp all day long. If you broke a company rule they do not have to pay, if you test positive for drugs or alcohol they do not , if you waited a long time before you let them know of the injury they do not. What kind of injury is it. I hope not back because they hardly cover thoese injury’s. ALSO what did your docotor say it was from if he put something other then the injury such as arthritis, unhealed injury from the previous one then workers comp will not pay. Get with them and ask why you were denied if you think it still should be covered then go to a lawyer and just sit down and talk to them and see what they say.
Workers comp is a No-Fault system.
IF you violated a company rule, you may STILL be able to get workers comp benefits – since workers comp is a NO-fault system.
Sure wish I knew WHICH STATE has jurisdiction over your claim.
IF you test positive for drugs / alcohol, It DEPENDS ON WHAT STATE has jurisdiction over your claim. In SOME states your claim may be denied, BUT in other states, there may be case-law that requires the injury occur solely because of the intoxication or being under the influence of drugs.
EVERY state has guidelines that require you to file your claim BEFORE the legal deadline. IF you fail to file before that legal deadline, you may lose your rights to benefits.
It ALSO depends on HOW your injury occurred, i.e. did you suffer an immediate and sudden accidental injury, or did the injury occur gradually? Judging from what I see here, it looks like you had a re-injury of an original injury – but it is not clear whether it was sudden or gradual .
Your RE-injury should be paid by workers comp, UNLESS your re-injury happened outside of your workplace – in that case they will not pay. IF you had settled your prior claim on a full-and-final settlement, workers comp is NOT obligated to pay.
IF your re-injury happened while you were performing your job, then workers comp should pay. Because it appears the workers comp carrier is denying your re-injury, FILE A NEW WORKERS COMP CLAIM FOR A NEW INJURY IMMEDIATELY. If your case goes to a Hearing, tell the Judge your situation, and most Judges will require the insurance company to pay one of those claims. The terms that they will try to argue are – whether you suffered a “Recurrence” vs. whether you suffered an “Aggravation” . These type of cases may take a long time, so if you are not familiar with this, I would suggest consulting with an attorney who specializes in workers comp cases.
While they should be required to pay for your recurrence, or aggravation, they are not required to pay for the underlying cause of any pre-existing conditions, such as arthritis, gout, etc.
BEFORE you meet with the attorney, ask the following questions
1 – Whether the attorney offers a FREE initial consult.
2 – Whether the attorney works on a “Contingency” basis. That means that you do NOT pay anything out-of-pocket. The Attorney ONLY gets paid if he wins your case.
If you wish, you can e-mail me for further help, and I would be happy to provide you with some free resources. Sure wish I knew WHICH STATE has jurisdiction over your claim.
I have over 20 years experience in workers comp