Here’s why workers’ compensation claims are denied in Virginia

You were injured at work and now need to deal with the financial distress. All employers in Virginia must pay for workers’ compensation insurance, and since this is a no-fault system, an injured worker doesn’t need to prove that the employer was at fault. Even if the accident was partly your fault, you can file your claim and get the deserved benefits. Insurance companies, unfortunately, try their best to deny and delay claims, which is why it’s best to consult an Ashburn workers’ comp attorney in advance. Let’s take a look at the common grounds on which workers’ compensation claims are typically denied. 

  • Non-Compensable Injury: This simply means that your injury doesn’t meet the requirements to qualify as a workers’ compensation injury. The thing is most injured workers don’t understand the term ‘non-compensable injury’, and they take things at face value. Insurance tactics are often hard to understand. If your claim was denied, for this reason, talk to your attorney to know more. 
  • Injury without explanation: Just because you were injured at work doesn’t mean you have a valid workers’ compensation claim. Your injury should be related to the work you do. If you just mention that you tripped and hurt yourself, the insurance company may say that they are not responsible for your clumsiness. You must report the injury accurately with all details. 
  • Pre-Existing Injury: This is one of the most common reasons why claims are denied in Virginia. The insurance company may say that you had the injury for years, and that’s a ground enough for them to deny your workers’ compensation claim. The laws in Virginia clearly state that if an injury on the job aggravates pre-existing injuries, the treatment costs can be covered by insurance. 
  • Lack of Medical Documentation: The insurance adjuster may say that they didn’t receive your medical records and could use that as a reason to deny your claim. You should consider sharing the information with the Virginia Workers’ Compensation Commission so that records are available to all parties concerned through the website of the Commission. 
  • Not Reporting the Injury: Insurance companies also use the tactic where they tell injured workers that didn’t report the injury on the same day, which is why their workers’ compensation claims were denied. This is a clear way of misleading an injured worker because you can get the benefits as long as you report the injury to your employer within 30 days from the date of the accident. 

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