Every year, tens of thousands of workers suffer injuries at the workplace in Connecticut. The last thing you may anticipate after suffering a workplace injury or illness is having your workers' compensation claim for benefits denied. However, this is the case on occasion.
Workers are entitled to benefits under Connecticut's Workers' Compensation Act, which mandates businesses to provide their employees with workers' compensation coverage. It's a no-fault system where an injured worker can collect payments to replace their wages and for medical care for their injuries, regardless of who was at fault for the workplace accident. This includes chronic ailments like carpal tunnel syndrome or digestive issues brought on by stress. With that said, why do claims get rejected?
When you are injured, you are probably expecting your workers' comp benefits as quickly as possible following the injury. However, the Connecticut Workers Compensation Commission requires information to be legally submitted before benefits can be distributed. If you miss one step in the claims process, you could see your claim be denied or your benefits being reduced.
The purpose of the workers' compensation benefit system is to protect businesses from lawsuits resulting from accidents or illnesses at work while providing employees with prompt benefits to rehabilitate from an injury and resume work.
There are certain instances when a workers' comp claim may be denied, but that doesn't mean the decision is final. With the help of a knowledgeable Connecticut workers' compensation attorney, you can ensure these scenarios do not happen and you know what options you can take if they do.
Reasons Why Your CT Workers' Comp Claim May Be Denied
There are a number of reasons why workers' compensation claims may be rejected. Here are a few situations where this may happen:
- Your employer or insurance provider thinks your illness or injury was pre-existing or unrelated to your job, and argues against benefits.
- Claim denials frequently occur because of incomplete or inaccurate information provided on your claim. This can result in your claim being denied, reduced or delayed, all due to a minor informational error.
- If the deadline for filing the claim has expired, your claim may be rejected. In Connecticut, you have one year from the time of your injury to file a claim, and three years from the first signs of symptoms for a work-related disease or illness related
- If you were intoxicated or participating in risky behavior that were not related to your employment and the accident occurred, your employer can call this into question.
- If you are not an employee, but rather an independent contractor.
These are all reasons how a workers' comp claim can be denied legally. In the case of an independent contractor being ineligible for these benefits, this is true but they have the right to sue for any injuries suffered while working in a personal injury lawsuit where there is no limit to the amount they may be able to collect for damages.
An employee who collects workers' compensation benefits forfeits their right to sue their employer in a personal injury case.
Been Denied? Here's What You Can Do
In Connecticut, there is a hearing you can ask for that gives you the chance to appeal your workers' comp claim if it was denied. It's important to work with a legal professional if you find yourself in this situation. They can give you some insight about why your claim was denied and the remedies available to you.
You should submit a request for an informal hearing as your initial step. When you submit the request, the process allows you and/or your attorney to provide further information and supporting proof regarding your claim.
If the issue between you and the employer's insurance provider cannot be settled before the hearing, it will take place, and the Commissioner will listen to all sides before making a possible recommendation. If the representative of the insurance company and you cannot come to an agreement, the case will be escalated to a formal hearing or trial.
The Attorneys At Brandon J. Broderick Are Available 24/7
The attorney team at Brandon J. Broderick has decades of expertise litigating workers' compensation claims in Connecticut. They provide knowledgeable counsel and tenacious advocacy on your behalf.
Send us a message to arrange a free consultation to go over your workers' compensation issue today.