Why Was My Maryland Workers` Compensation Claim Denied?
Workers’ compensation is a type of benefit that is offered by the employer to the employee in case of a work-related injury. The benefits are intended to cover any medical costs that the employee may incur as a result of that injury as well as any wages the worker may lose due to the inability to get back to work during the recovery phase. The primary goal of a workers’ compensation claim is to ensure that the employee does not have to bear the financial costs associated with the work-related injury and can focus on recovering and getting back to work.
Under the Virginia Workers’ Compensation Act, all employers are required to carry workers’ compensation insurance. This includes all employers who regularly employ more than two part-time or full-time employees including subcontractors. There are no exceptions to this rule, and every employer has to abide by it. If the employer does not carry this insurance, they can be penalized. Any injured workers in this scenario will still be eligible to receive workers’ compensation.
As per the Virginia Workers’ Compensation Act, the following injuries will be covered:
- The injury occurred at work or during a work-related event or function
- The injury was the result of a specific work-related activity
- The injury occurred suddenly but was at the workplace or occurred within the scope of work-related activity.
Benefits can include medical benefits, wage loss replacement benefits, permanent partial disability benefits, permanent total disability benefits, death benefits and other benefits such as mileage reimbursement, etc.
It is important to note that workers’ compensation benefits only apply to workers who have been injured at the workplace while performing a work-related task or outside the workplace also while conducting a work-related activity or task. Any injuries that arise due to the workers’ own behavior in their own time such as going to or coming back from work or during lunch break etc. are not eligible for workers’ compensation. In addition, if the worker gets into a personal conflict with another coworker or if the worker engages with a third party on an issue which is not work-related but is conducted at the workplace, any injuries that may arise from such an interaction are not covered by workers’ compensation.
How Can a Maryland Workers’ Compensation Claim Be Denied
While workers’ compensation benefits are a right of employees in Alexandria, VA, there are situations when claim approvals are delayed, or claims are denied. This can happen due to several factors:
- Employees in Alexandria, VA are required to report the injury to their employer immediately and to file a claim with the Virginia Workers’ Compensation Commission within two years of the accident. If the employee fails to meet these requirements or fails to do so within the specified time frames, their claim can be denied. That is why it is important for all employees to make sure that they report their work-related injury to their employer as soon as possible. They should include their name, contact information, the details of the accident and the extent of their injuries. The employee must do this within 30 days of the accident, or the employer can simply refuse to pay. Similarly, the employee must file their claim within two years. The claim can be filed either in person, by mail or online. The important thing to ensure is that it is done within the specified timeframe. Employers are also obligated to report the accident to the Virginia Workers Compensation Commission within ten days of the accident or within ten days of being aware that the accident occurred. This is called the “First Report of Injury” (FROI), and every employer has to file such a report in the event of an accident.
- There are situations when the employer disputes your claims that the injury was work-related. This can happen if the employer does not believe that the injury occurred at the workplace or if it did, the employer is unsure that the injury happened while the worker was engaged in a work-related activity. Employers can dispute such claims, and that is why it is important for all workers to make sure they report the accident immediately, and they provide as much detail about the incident as they possibly can. This can help avoid any gaps in communication and can also help the worker convince the employer that the injury was indeed work-related.
If your Claim is Delayed or Denied, Reach Out to a Maryland Lawyer About Your Case
If you have been injured in the workplace and you do not know how to proceed, contact our lawyers at Ashcraft & Gerel, LLP, today. Workers’ compensation benefits are your right, and you are entitled to be compensated for any medical costs and financial losses that you incur as a result of a work-related injury. We understand that sometimes employers are difficult and can refuse to accept your claim resulting in delays in your claim approval. We also understand that sometimes workers are afraid that if they go against their employer and file a claim, they would lose their job. However, you need to understand that it is illegal for employers to threaten workers that way.
The legal system is designed to help you recover from your injuries so that you can go back to work. During this time, the law provides you these benefits so that you do not have to deal with the financial consequences of the accident and your injuries and can focus on improving your health and becoming part of the workforce again. Nobody can take that right away from you. If your claim has been denied or if your employer is proving to be very difficult, contact our lawyers today at 1-844-707-8422, and one of our associates will help you determine the next course of action. We have some of America’s best lawyers on our team, and we have recovered over $1 billion for our clients. Call us now so that we can help you get the benefits you deserve.