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Why employers or insurers might dispute a workers’ comp claim

On Behalf of | Apr 27, 2023 | Workers' Compensation |

The outcome of a work-related accident could pose a significant threat to your health and leave you facing a variety of challenges in life. Preparing for the recovery process can seem an intimidating task, and you may worry that you will struggle to make ends meet when dealing with the financial fallout involved. 

While you may be eligible for monetary aid via the workers’ compensation insurance system, preparing to navigate this process can be a complex task. There are also certain scenarios in which your employer or the insurer might dispute the claim. Facing a similar situation can prove a stressful and daunting process. 

Claim disputes 

Knowing what might lead employers or insurers to dispute your claim for workers’ comp benefits could be vital to taking steps to protect against such issues. Some prevalent causes for disputes may include: 

  • Negligent behavior: One common reason for disputes might involve the argument that the incident was not work-related and instead resulted from negligent behavior, such as horseplay. 
  • Unlawful activity: The presence of impairment or a violation of workplace safety rules could also prompt allegations that the accident that left you with injuries occurred due to unlawful behavior. 
  • Lack of treatment: Seeking medical care and maintaining thorough documentation of your injuries and treatments may also be vital, as lack of medical evidence could impact the outcome of your situation. 
  • Policy terms: Your employer’s workers’ compensation policies may also include terms such as a list of approved medical providers. If you see someone who is not on this list, it may affect your eligibility. 

The other parties involved may argue that there is a lack of evidence to support your claim. Being thorough when reporting and documenting the incident may be vital to warding off such issues. 

Preparing to file a workers’ comp claim 

While the presence of disputes might affect your eligibility to receive the benefits you deserve, there may be steps you can take to help protect against such concerns. Seeking advice on your rights and options and on every factor to consider might be vital to preparing to take a thorough approach to every step of this process. This could provide you with insight on the challenges you might face and help you prepare to take every necessary measure to safeguard your future in North Carolina. 

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