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Why would a workers’ compensation benefits claim be denied?

Business owners in Ohio must provide certain insurance coverage for all their employees. Workers’ compensation benefits typically cover any injury or illness suffered on the job, and the severity generally determines the level of coverage. It could be medical only or with disability benefits if there is a period of absence from work. However, not all claims are approved for payment.

Why would a claim be denied? There are strict time limits related to the period within which an employer must be informed of the injury, and for the employee to file the claim with the insurer. Some circumstances such as horseplay or the injury being unrelated to work may cause the employer to dispute the claim. The same may happen if no medical treatment was necessary or no documented evidence such as doctors’ bills or medical reports were provided with the claim.

There are also some types of injuries and illnesses that are rejected because it’s not possible to prove they were related to work. Unlike visible injuries such as broken bones and blood-gushing wounds, an employer might oppose something like repetitive stress injuries or lung conditions that developed over time. Injuries suffered during lunch breaks or at work functions are also often disputed.

These are but some of the reasons why injured or ill employees in Ohio seek the services of experienced workers’ compensation attorneys. There is no need to accept a denial of benefits that can cause financial instability. A skilled lawyer can navigate the administrative proceedings and/or the appeals process in pursuit of the benefits for which the employee qualifies.

Source: FindLaw, “Workers’ Comp Denied? Here are Your Next Steps“, Accessed on April 28, 2017