Fighting For
Employee And Union Rights
Fighting For
Employee And Union Rights

Common reasons why workers’ comp claims are denied

On Behalf of | Apr 28, 2023 | Workers' Compensation

Michigan’s workers’ compensation program provides benefits to employees who experience injuries on the job. These benefits include payment for medical expenses, lost wages and vocational rehabilitation. However, not all claims are approved, and many employees find their claims denied for various reasons.

Here’s what you should know about Michigan workers’ compensation claim denials.

Failure to report the injury promptly

One of the most common reasons workers’ compensation claims are denied in Michigan is because the employee failed to report the injury on time. Michigan law requires employees to report their injuries to their employer within 90 days of the accident or within 90 days of discovering the injury. Failure to report the injury in a timely manner can result in a denial of benefits.

It’s essential to report any work-related injury or illness to your employer as soon as possible. Even if you don’t think the injury is serious, it’s important to document it in case it worsens over time.

Pre-Existing Conditions

Another common reason why workers’ compensation claims are denied in Michigan is due to pre-existing conditions. If a work-related injury aggravates your pre-existing condition, you may still be eligible for workers’ compensation benefits. However, proving that the injury was caused by work-related activities, not the pre-existing condition, can be challenging. Insurance companies often deny claims based on pre-existing conditions, so providing detailed medical records and documentation to support your claim is important.

Lack of Evidence or Proof

Insurance companies require proof of a work-related injury or illness to approve a workers’ compensation claim. If there is not enough evidence or documentation to support your claim, your benefits may be denied. It’s important to provide as much detail as possible when reporting the injury and to keep detailed records of all medical treatments and expenses related to the injury.

Additionally, insurance companies may require a medical examination or an independent medical evaluation to confirm the injury and assess its severity. If you must undergo a medical exam, attending the appointment and providing accurate information is essential.

If your workers’ compensation claim is denied in Michigan, you have the right to appeal the decision through the Board of Magistrates. It’s important to work with an experienced workers’ compensation attorney who can help you navigate the appeals process.