Reasons Your Massachusetts Workers’ Compensation Claim Can Be Denied

Posted on behalf of Janet, Janet & Suggs, LLC on February 16, 2017 in Workers' Compensation Blog Posts

Unfortunately, workers’ compensation insurers will look for any reason to deny your Massachusetts workers’ compensation claim.

If you review the most common reasons claims are denied, you can determine how to improve the odds of your claim being approved.

Improper Reporting

Under Massachusetts workers’ compensation laws, employees are required to submit a written report about on-the-job injuries to their employers as soon as possible. If an employee does not provide prompt, accurate reporting about his or her medical issues, the employer could deny the claim.

Another reason for prompt reporting is that it will make it easier to gather evidence about your illness and what caused it. If you wait, you could forget crucial details and evidence could get lost.

After reporting your injuries in writing, Massachusetts workers’ compensation law states that your employer must notify its workers’ compensation insurer. The employer’s report should include the following information

  • The injury or illness suffered
  • Date and location where the injury occurred
  • Name, age, sex and occupation of the injured employee
  • How and why the injury occurred
  • Names of witnesses
  • Actions that led to the injury

Notifying the insurer creates a deadline to start paying benefits or deny your claim.

Injury Not Work-Related

In Massachusetts, the burden falls on the worker to prove he or she has a condition that qualifies for benefits.

One of the qualifications is that the injury or illness had to have arisen during the course of your employment. This means that a pre-existing or degenerative illness that is not work related will not qualify for benefits.

However, if your job caused a pre-existing condition to become aggravated, you may be eligible for workers’ compensation.

In many cases, you will need to show that your injury was caused by a single incident that occurred while you were working.

However, repetitive motion injuries, like carpal tunnel syndrome, often develop over several years. In this case, you would not need to show that the injury was caused by one particular incident.

Employee Status

Any full or part-time workers who earn salary or wages in the state could be eligible for workers’ compensation benefits, according to Massachusetts General Laws Part 1 Title XXI Chapter 152 Section 1.

However, your employer or the workers’ compensation insurer may claim you are an independent contractor and therefore ineligible for benefits.

Under state law, a worker is classified as an employee unless the employer can prove:

  • The worker is not under the direction and control of the employer when performing duties
  • The worker provides a service not part of the employer’s typical business
  • The worker engages in regular independent trade of the same category of service provided to the employer

If your workers’ compensation claim has been denied, the leading Boston workers’ compensation lawyersat Janet, Janet & Suggs, LLC can help you craft a winning appeal so you obtain all of the compensation you are entitled.

Call 1-877-692-3862 or complete our Free Case Evaluation form.

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