Filing a workers’ compensation claim in North Carolina should be a straightforward process, but unfortunately, claims are often denied for various reasons. It is important to know that although an employer or insurance company may deny your case, that does not mean that it is over. A denial can be just one step in the process and it is important to know your rights going forward.
Common Reasons NC Workers’ Comp Claims Are Denied — and What to Do
1. Failure to Report the Injury on Time
North Carolina law requires that you notify your employer of your workplace injury within 30 days of the incident. If you delay reporting, the insurance company might argue that your injury is unrelated to work or isn’t valid. Life can be chaotic after an injury, but notifying your employer as soon as possible is critical. If you missed this deadline, don’t panic. We can help evaluate your circumstances and determine if there are exceptions or ways to appeal the denial.
2. Disputed Connection Between Your Injury and Work
The workers’ comp insurance company might argue that your injury didn’t happen during the course of your employment. For example, they could claim it occurred off the job or wasn’t related to your work duties. We know how frustrating these disputes can be, especially when you know the truth. Our team will gather the evidence needed to prove that your injury is work-related, including medical records, witness statements, and expert opinions.
3. Failure to Seek Prompt Medical Treatment
If you didn’t seek medical treatment right after the injury, the insurance company might question the severity or legitimacy of your claim. We understand that sometimes delays happen, whether due to confusion, financial concerns, or lack of access to immediate care. Our attorneys will work to establish a clear timeline of events and demonstrate the validity of your injury.
4. Pre-Existing Conditions
Insurance companies often use pre-existing conditions as a reason to deny claims, arguing that your injury was not caused by your job. While it’s true that pre-existing conditions complicate claims, North Carolina law allows workers to receive benefits if their job aggravated or worsened an existing issue. We have the expertise to handle these complex cases and ensure you’re treated fairly.
5. Administrative Errors or Missing Paperwork
Workers’ compensation claims involve a lot of paperwork, and missing a deadline or failing to provide necessary documentation can result in a denial. We understand how easy it is to feel overwhelmed by the process. Our team can take over the administrative burden, ensuring your claim is filed accurately and on time.
How We Can Help
At Kornbluth Ginsberg Law Group, we approach every client with empathy and determination. We know that a denied claim can leave you feeling hopeless, but it’s important to remember that a denial isn’t the end of the road. Our workers’ compensation team has extensive experience appealing denied claims and helping injured workers secure the benefits they need to heal and move forward.
You don’t have to face this challenge alone. If your workers’ compensation claim has been denied, contact us online today or call us 24/7 at 919-980-9895 for a free consultation. We’re here to listen, fight for your rights, and get you the support you deserve.
