What Are Reasons Workers’ Comp Claims Are Denied?


Why your California workers' comp claim could be denied. Workers’ compensation benefits can provide you with the means to pay for various expenses after a workplace injury or illness. These expenses include doctor visits, medications, lost income and funeral expenses (paid to the family of a deceased worker). However, there are multiple reasons why your claim could be denied. Common reasons workers’ comp benefits are denied in California include but are not limited to:

  1. You are not considered an employee. Employers may attempt to deny your claim by arguing that you are an independent contractor and not an employee. In other cases, they may claim that you were not employed at the time of the accident.
  2. Your injury or illness is not work-related. Workers’ compensation benefits can only be recovered for on-the-job injuries or illnesses. These are injuries or illnesses that arise from your job duties or work environment.
  3. You made paperwork or filing errors. There are certain procedural steps you must take while reporting a work injury and applying for workers’ comp benefits. If you miss deadlines or make other mistakes during this process, then your claim for benefits could be denied.
  4. Your injury or illness is not compensable for other reasons. There are several other reasons why injury or illness claims are denied. For instance, you cannot recover compensation if your employer can show a proximate cause between an injury and drug or alcohol intoxication.

What If My Claim Is Denied?

Our blog only discusses a small handful of examples of why your claim could be partially or completely denied. You should speak to a workers’ comp attorney right away if you believe your claim was denied on false pretenses.The Gilroy workers’ comp attorneys at Cramer & Martinez, LLP could help you determine whether it would be possible to still receive benefits. You may schedule a free consultation with one of our attorneys by calling (408) 763-8336 or by using our online case review form.

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