When may my workers' compensation claim face pushback?


On its face, workers' compensation may seem relatively simple. If you are injured on the job, then you may recover compensation to help offset your lost wages and medical expenses. Yet, there are many gray areas when it comes to workers' compensation, and employers and insurance companies may try to use these to deny you compensation to which you are actually entitled. You therefore need to be aware of some of this issues so that you can push back against those who may seek to deny you workers' compensation.

First, you may be denied workers' compensation because you have a medical condition that existed prior to the workplace accident. However, if you claim that the workplace accident exacerbated or accelerated your already existing injury, then you still qualify for workers' compensation. This type of situation often arises with back injuries.

Second, employers and insurance companies may try to claim that you were outside the scope of your employment when you suffered your injury, specifically if you were on break, at lunch, or attending a work-sponsored activity. Yet, even during these times, you may be within your scope of employment. So, even if you are hurt while sitting in a defective chair in the break room, you may qualify for workers' compensation benefits.

Third, issues may arise when your claim is based on work-related stress or a mental health condition. Here, too, though, you can qualify for benefits as long as you can show that your condition developed because of your job's demands or harassment by your boss or co-worker.

Workers' compensation is pretty broad, but it is not always black and white. Thus, if you are facing pushback with regard to your claim, then you should consider whether seeking legal assistance will help you bolster your claim and increase your likelihood of obtaining the money you need to get by while you focus on reclaiming your health.

Source: FindLaw, "Workers' Comp In-Depth," accessed on Feb. 5, 2017

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