If your benefits are denied, it can be very stressful for you to figure out how to cover your medical bills and other finances.
If you are a worker in Missouri, then your employer is required by law to have workers’ compensation coverage to ensure that they can pay for any worker who is injured while on the job. Therefore, when you suffer an injury or illness on the job, you expect to receive workmens comp benefits for your medical treatments and lost wages.
However, it happens too often that an injured employee files a workers compensation claim and is denied part or all of their claim. When this happens it can be very stressful for a worker to figure out how to cover their medical bills and stay in control of their finances.
If you have been denied benefits, you need to consult with an experienced workers’ compensation lawyer who understands your rights under Missouri law.
Who is Eligible to Collect Workers’ Compensation?
Just because you are at work and get hurt, does not automatically ensure that you are entitled to receive workers’ compensation benefits. There are conditions that need to be in place to ensure that you are eligible to collect benefits for both lost wages and medical costs.
To be eligible, you must first prove that the injuries that you claim were actually sustained while you were performing an activity as outlined by the conditions of your employment duties. It is not enough to merely be in the workplace and hurt yourself, you have to show that your injuries were due to doing something that you were required to do as a condition of your job.
For example, if you fell down the stairs and hurt your ankle while walking into work, then you would likely not be eligible to collect workers’ compensation. However, if you were required to move packages up and down the stairs, and while you were moving things you tripped on a step and broke your ankle, then that would be covered. In addition, you also have to prove that you were actually injured, and to what extent.
Common Reasons Claims are Denied
If an insurance company can prove that your accident didn’t happen when you were engaged in a work-related activity, then they might be able to deny you coverage.
Another reason that they might try to not pay for your injuries is if they believe either that your injuries aren’t as bad as you claim, or in some instances, that you didn’t even hurt yourself at all.
If the workers’ compensation insurance company believes that you aren’t being honest about your injuries – about how they happened, that they happened, or that you were injured at all – they may require that you have an independent medical examination (an IME). If they ask that you submit to an IME, you are required to be evaluated or you could risk your eligibility for benefits.
Contact Us for a Free Consultation
For more than 20 years, the Law Office of James M. Hoffmann has been helping injured workers receive the benefits they need and deserve. If you have been injured at work and your claim is being denied, call us at (314) 361-4300 or fill out our online case evaluation form. We will help you navigate the workers compensation process.