If you’ve been injured at work, there is a good chance that you are counting on workers’ compensation to see you through your recovery. Successful workers compensation claims provide Missouri workers with temporary and permanent disability benefits and coverage of medical expenses. If your employer, or its insurer, provide you with notice indicating that they have denied your claim, it can be a rude awakening. Many Missouri work comp claims are denied initially by employers. Here are several common reasons why work comp claims are denied.

Five Reasons Why Work Comp Claims Are Denied

1. Waiting to report the injury. It is important to report any unusual incident, accident or pain to your superiors immediately. You should fill out any written report that your employer has to put them on notice of the potential claim. Doing so paves the way for a successful workers’ compensation claim if you later discover that the incident caused you a compensible injury.

2. Lack of medical evidence. Missouri law requires that your injury be related to your work. Therefore, getting a medical opinion provides you with documentation to prove your injury is work related.

3. Pre-existing condition. If you have a pre-existing condition, your claim is more likely to be denied. As a result, you will need medical documentation to prove that your injury is new, or that the accident exacerbated the pre-existing condition.

4. Drug or alcohol use.  If your employer suspects you were under the influence of drugs or alcohol when injured at work, they will probably deny your claim.

5. You don’t meet the statutory definition of an employee. Missouri law requires workers compensation coverage if the employer has five or more employees or if there is one employee in a construction setting. If there are fewer than five employees, you may not be covered. Additionally, railroad, postal, and maritime workers are covered under federal laws and not by Missouri Workers’ Compensation Laws. Similarly, other non-covered employees include: farm labor, domestic servants in a private home, occasional labor performed for or related to a private household, qualified real estate agents, direct sellers, volunteers of a tax exempt organization which operates under the standards of section 501(c)(3) or 501(c)(19) of the federal Internal Revenue Code where such volunteers are not paid wages. Further, sports officials or contest workers for interscholastic activity programs or amateur youth programs who are not employed by the sponsor of the event are not employees.

We Can Help

When work comp claims are denied, it may be difficult to pay your bills, support your family and get medical attention. The attorneys at Kennedy, Kennedy, Robbins & Yarbro, LC, understand Missouri law. We can assist you in turning around the initial claim denial. Seeking legal advice can give you a better chance of receiving the benefits you need to move forward. If you have been injured at work, please contact us to discuss your workers compensation claim. You can also call us at (573)686-2459. We are here for you when you need us.