There are many reasons employers fight workers’ compensation claims, some valid and others less so. Often, it’s simply a matter of money. When an employee files for workers’ compensation, it causes the employer’s insurance premiums to go up. As a result, many employers dispute claims in an effort to avoid skyrocketing premiums.
In other cases, an employer might dispute a workers’ compensation claim in order to discourage other employees from filing for workers’ compensation. They may believe that paying out a claim—even a legitimate claim—could set a precedent for other employees to seek benefits, leading to even greater increases in insurance premiums for the employer. The employer may even wish to protect its image, internally or externally, which could lead to the employer aggressively fighting an employee’s workers’ compensation claim.
Often, employers fight workers’ compensation claims because they do not believe that employees have been seriously injured, or that their injuries are not work-related. Your employer might argue that you have a preexisting condition, or even that you are outright lying about your injury.
But when is an employer’s dispute of a workers’ compensation claim valid?
There are many times when an employer may legitimately dispute a workers’ compensation claim. Examples include instances in which:
- An employee does not sustain a serious injury, requiring them to take time off work
- An employee’s injury did not occur at work or within the scope of their employment
- An employee does not require medical treatment for their injury
- An employee violated company policy (e.g., was intoxicated), leading to their injury
- An injured worker is not covered by workers’ compensation (e.g., independent contractors)
- An employee failed to notify the employer of their injury within the applicable timeframe
If you do not qualify for workers’ compensation, your employer may dispute your claim, and the insurance company will deny you benefits.
Additionally, mistakes on your workers’ compensation claim or during the filing process—including missed deadlines or missing information—could result in your claim being denied. Because of this, it is important that you work with an experienced workers’ compensation lawyer who can help guide you through the process.
How to Avoid Disputes from Your Employer When Filing for Workers’ Compensation
While you can’t always stop your employer from fighting your workers’ compensation claim, there are several things you can do to help ensure that your claim is ultimately accepted and that you receive the benefits you are owed.
First, you should make sure that you qualify for workers’ compensation. Before filing, you should check whether you are a covered employee and whether your employer carries workers’ compensation insurance. You should also make sure that your injury or medical condition is covered by workers’ compensation. In Kentucky, any injury, illness, or medical condition that occurs in the workplace, as a result of one’s working conditions, or otherwise within the scope of a worker’s employment is covered.
Next, you should make sure that you meet all applicable deadlines. This means notifying your employer of your work-related injury or illness as soon as possible and filing a workers’ compensation claim within two years. If you fail to act promptly, you could lose your right to recover benefits.
It is also very important that you carefully and correctly fill out all forms, documents, and paperwork associated with your claim. Any mistakes on your claim could serve as grounds for denial.
At Kentucky Injury Law Center, we recommend that you reach out to an experienced workers’ compensation attorney if you have suffered a job-related injury or illness. This is especially true if your employer is disputing your claim, or if the insurance company has denied you benefits. Our Kentucky workers’ compensation lawyers know how to protect your rights and can fight back against your employer’s efforts to dispute your claim. We can also assist you in appealing a denied claim, as well as taking the proper steps to avoid issues from the start.