In Texas, as in any other jurisdiction, there are several reasons why a work injury claim may be rejected.
Each work injury claim is unique because the circumstances surrounding the injury, the severity of the injury, the individuals involved, and the applicable laws and regulations can vary from case to case. Even if two workers sustain seemingly similar injuries, there may be differences in the contributing factors or the impact on their ability to work and recover.
Here are some common factors that could lead to the denial of a work injury claim in Texas:
- Failure to report the injury promptly: Texas law requires employees to report work-related injuries to their employer within 30 days of the incident. If you fail to report the injury in a timely manner, the insurance company may use this as a reason to reject your claim.
- Lack of medical evidence: To support your work injury claim, you need to provide sufficient medical evidence that demonstrates the extent and nature of your injuries. If the medical documentation is insufficient or lacks clarity, the insurance company may reject your claim.
- Pre-existing conditions: If the insurance company can prove that your injury or condition existed before the work-related incident, they may reject your claim on the basis that it is not directly related to your employment.
- Violation of company policies: If you were injured while violating company policies, such as engaging in unauthorized activities or being under the influence of drugs or alcohol, your claim may be rejected. This is particularly relevant if your employer has established clear guidelines and policies regarding safety procedures.
- Independent contractor status: Independent contractors are typically not covered by workers’ compensation insurance. If the insurance company determines that you are an independent contractor rather than an employee, your claim may be denied.
- Statute of limitations: In Texas, there is a specific time limit within which you must file a workers’ compensation claim. If you miss the deadline, your claim may be rejected.
- Lack of causation: To have a valid claim, you need to demonstrate that your injury directly resulted from a work-related incident or conditions. If the insurance company disputes the causation, they may reject your claim.
Injured at Work?
We know we can help you!
Non-Subscriber claims in Houston, Dallas, Austin, Corpus Christi, San Antonio and The Rio Grande Valley.
It’s important to note that each work injury claim is unique, and the circumstances surrounding your case may vary.
Consulting with an experienced workers’ compensation attorney in Texas can provide you with personalized advice based on the specifics of your situation.
Can You Survive a Claim Denial?
Yes, you can! You have to proactive about figuring what the rules of the game are. If you don’t, you have a slim chance of getting the medical attention that you deserve and getting back to work. Remember that the work injury claim under your employer’s insurance is the systems used by your employer and the insurance company to make it appear that you don’t have any other rights to seek compensation for your work injuries. After a work injury, you have to consider whether or not you have rights to file a lawsuit against your employer for failing to provide you with safe work place. We focus on determining whether you have a good case against your employer and providing you with a comprehensive plan on how you can survive the injuries and get your life back!
Read also: Why Was My Claim Denied?
At Sandoval Law Firm, PLLC, as your attorney, I focus on making sure you understand the process and the plan that my firm is going to implement to get your life back! If you’ve been injured at work, do your research and give us a call!
- Do I Have A Good Texas Worker’s Compensation Case?
- What if my worker’s compensation claim is denied, Can I still sue my employer for negligence?
- What steps should I take to protect my rights?
- What kind of Work Injury Coverage Can My Employer Have?
- What are Texas Non-Subscribers?
- What is the likelihood that my employer is a Texas Non-subscriber?
- How are Workers’ Compensation Claims Different from Non-subscriber Claims?
- Should I Go On FMLA In My Workers’ Compensation or Non-Subscriber Case?
- Should I Sign Any Documents From my Employer after I’ve Suffered a Work Injury?
- Should I Apply for Short-Term or Long-Term Disability In My Texas Non-Subscriber Case?
- What Is an employment benefit plan or summary plan description?
- How Much Time do I have to file my non-subscriber Claim?
- How soon so I have to report my injury?
- Why Can’t I Get A Response from the Claims adjuster?
- The Role of the Adjuster in Texas Non-Subscriber Cases?
- How Can Your Work Injury Claim in Texas Be Rejected?
- Can A Texas Work Injury Case Be Resolved In Less Than A Year?
- Why Was My Claim Denied?