Can An Employer Refuse to Give Me a Workers’ Comp Form?
An employer is not obligated to automatically cooperate with someone wishing to file a workers’ compensation claim. Obtaining a claim form is a crucial part of the workers’ comp application process — without a form, there will be no compensation. While it is generally the employer’s responsibility to pay premiums to provide workers’ comp coverage, there are limitations on what qualifies for benefits, as well as situations in which the employer may refuse to participate in claim filing or to support an employee’s efforts to receive payments.
For one thing, getting injured while on the clock doesn’t automatically qualify you for workers’ comp. Examples of work illnesses and injuries eligible for workers’ comp claims include:
- Bone fracture;
- Head injury;
- Heart disease;
- Repetitive sprain injury;
- Spinal cord injury.
However, even if an employee does have any of the above qualifying injuries and/or illnesses, their employer may still refuse or deny to provide them with a claim form. While there are some legitimate grounds for such a refusal, injured employees may need to find a local attorney to navigate the process and determine if their claim warrants legal help.
Why Your Employer May Deny and/or Refuse to Provide a Workers’ Comp Claim Form
While it may not make sense to the employee, there are multiple reasons as to why an employer may refuse to cooperate with the claim process. Keep in mind that while some of the reasons listed below may make you ineligible for workers’ comp, you may still be eligible for other forms of compensation like short-term or long-term disability.
Listed below are a few reasons why your employer may refuse to give you a claim form or deny your claim entirely.
Failure to Report In a Timely Manner
Claimants typically have between one week and 90 days to file a claim depending on their local laws. If an employee attempts to file a claim beyond the allotted time, their employer has the right to refuse to provide them with a claim form.
To prevent this from happening, those who are injured at work will want to begin the claim process as soon as possible.
Lack of Medical Evidence
Accumulating eligible medical evidence like injury reports, witness statements, security footage, and medical records are crucial measures to take to help ensure the claim gets taken seriously. If you know there were security cameras around the area of the incident, ask for a copy of the video. If able, make additional copies of the video for your records and to provide to individuals, like lawyers and/or the insurance company.
The Employee Was Under the Influence at the Time of the Injury
It shouldn’t come as a surprise that being under the influence at work — whether it be alcohol or drugs — could result in claim denial. The employer may see you as unworthy of being able to comply with basic safety rules and regulations and are willingly putting yourself in harm’s way if working while under the influence.
A claim denial isn’t the worst that could happen if choosing to work under the influence — write-ups, injuries to others, and/or job loss can occur as well.
The Injury or Illness Is Related to a Pre-Existing Condition
If you choose to work with a pre-existing injury or illness, such as a broken bone. You can not file a workers’ comp claim if that injury/illness worsens while on the job. Because the initial injury wasn’t caused while working, your employer may feel that it is unfair to state that you injured yourself while on the job.
It is essential to discuss any pre-existing injuries or illnesses with your employer upon hiring. It is also essential to inquire with your employer to see if your pre-existing injury/illness qualifies you for any other benefits. Such as short-term or long-term disability.
The Injury/Illness Requires No Medical Attention
Simply falling and scraping a knee or getting a bruise is not a cause for a workers’ comp claim. However, if you do receive a minor injury while on the job, you should still tend to the injury (i.e. a cut, minor burn, or scrape) with the help of the nearest first aid kit. If you are questioning whether or not your injury needs medical attention, talk with your manager. Be honest while explaining what happened and how you feel. For instance, if you hit your head and it’s immediately followed by a sense of confusion and a headache. Even if you think you’re okay, it still may be best to seek medical attention — for these are signs of a concussion.
Examples of injuries and illnesses that are not required to be recorded are:
- Injuries or illnesses that involve symptoms that surface at work but result solely from non-work-related events;
- Injury or illness that is the result of an employee eating, drinking, or preparing food or drink for personal consumption. (i.e. the employee is injured by choking on a sandwich while at work.);
- If the illness is the common cold or flu.
There Is Evidence That a False Claim Was Filed
Your employer has every right to deny your claim if they feel it was falsified in any way. Common signs of a false workers’ comp claim that they may be looking for include:
- Department gossip about the injury;
- Inability to get a clear understanding of what happened;
- The injured individual is refusing to seek medical diagnostic treatment proving their injury.
Your Work Injury Has No Witnesses
As mentioned previously, having witnesses to the incident is important to complete the claim. These individuals can provide unbiased insight as to what happened. If there are no witnesses around, or witnesses who claim they didn’t see anything. It could deter your employer from wanting to believe you need a form to file a claim.
How Long Do I Have to File or Report a Workers’ Comp Injury?
Depending on the state in which the employee resides and the policies of the insurer, they will have between one week and 90 days to file a claim. The sooner the claim is filed, the sooner they can proceed with the claim process. Late reporting is still possible, however, the insurance company may deny the claim. An appeal can be filed in response to the denial. But this will only prolong the process even further, preventing you from getting your compensation in a timely manner.
It is important to note that just because a claim is filed, it doesn’t mean it will be approved. Insurance companies may request more information from your employer regarding the incident. If they feel the evidence provided isn’t enough to support your claim. This may require a claim extension, prolonging the process even longer.
Work With an Experienced Local Lawyer
If you feel that none of the above apply to you, and your claim was wrongfully denied. You should contact a lawyer with expertise in workers’ comp cases. They can provide an outside perspective on whether or not the injury you obtained while at work is damaging enough to earn you compensation.
Submit a request online or call us today at (866) 345-6784 to get in touch with an attorney in your area!