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3 Potential Reasons Why Your Workers’ Compensation Claim Might Be Denied

Workers’ compensation insurance is a legal requirement for most employers in Oregon. It is a valuable precaution that protects your boss from being sued and you from the negative financial impact of an on-the-job injury.

According to an Oregon Occupational Injury and Illness Survey, almost 59% of the over 50,000 reported cases of workplace injuries or sicknesses in 2019 lead to a job transfer, some form of work restriction or the need to take days off. Workers’ compensation benefits exist for situations like these. However, the problem arises when workers’ compensation claims are denied, which may occur for several reasons. 

  1. Preexisting Conditions

If you had a medical condition prior to your accident or illness, the insurance company may try to use that as an excuse to wriggle out of paying. It might claim that your injuries are due to your preexisting condition rather than the actual incident. 

  1. Purposeful Neglect

Insurers may also try to say that you were hurt while horseplaying around or because you were intentionally neglectful rather than as a direct result of your work. You still qualify for workers compensation benefits Oregon as long as you did not purposefully cause your injury, even if you were partially or fully to blame. For instance, being inattentive may result in an accident, but if it wasn’t on purpose, you still have the right to benefits. 

  1. Reporting Delay

You need to immediately report any injury to your manager. Insurance companies do not like delays in reporting. Even if you report within the allotted period you can report an injury (five days in Oregon), not doing so as soon as possible may mean you have to wait longer to get your benefits.

It is common for workers’ compensation claims to be rejected once or even twice or to experience delays in the process. Denial is not the end. You can always appeal a rejected claim.