A worker should not have to fear financial ruin from having to pay medical bills to treat a serious work-related injury. Many Ohio residents work at a place that carries workers’ compensation coverage. However, approval for a workers’ comp claim is not automatic. In some cases, a worker may not receive approval for a comp claim.
A worker still has the option to appeal a denial, but time may be of the essence. Many workers want or need their coverage as soon as they can get it. Learning why a governing entity like the Ohio Bureau of Workers’ Compensation may turn down a claim could help a worker present a case more likely to receive approval.
Lack of information
According to the Ohio BWC, reasons for denying a workers’ comp claim will vary according to the specific circumstances of a worker’s claim. However, the main reason the bureau denies claims is because the worker does not supply enough information in the claim.
There is a time limit of 28 days for the BWC to issue a decision on whether to approve a claim. In the event the BWC does not receive enough information within this time period, the BWC will not approve the claim. Regardless of the reason for the denial, the BWC should supply an explanation of the denial in the BWC order.
Other reasons to deny a claim
FindLaw describes reasons besides a lack of information that may cause a workers’ compensation authority to deny a claim. Sometimes a worker does not report an injury within a specified time frame or files a claim too long after the injury had occurred. Time requirements are important and can cause a worker to lose out on benefits if the worker does not observe them.
An employer may also dispute the claim, saying the worker’s injury did not occur at work or was the result of irresponsible behavior on the part of the worker. If a worker believes otherwise, the worker may gather sufficient evidence to prove that the claims of the employer are wrong. Without this evidence, the worker may lose out on coverage.