5 reasons workers’ compensation benefits can be denied

On Behalf of | Apr 26, 2017 | Workers' Compensation

Getting sick or hurt on the job can significantly disrupt your life. Not only are you dealing with the pain and fear of a health condition, but you also can be unable to work which can make it even more difficult to take care of yourself and get the treatment you need. Thankfully, there are workers’ compensation benefits available to workers who are injured on the job in Massachusetts.

However, as noted in this guide from the Department of Industrial Accidents in Massachusetts, roughly half of all workers’ compensation claims are disputed. This means that there is a very real possibility your claim could be among those that an insurer or employer denies. You can work to avoid this by knowing — and avoiding, if possible — some common reasons why claims are denied. These reasons are listed below.

  1. You are not eligible for workers’ compensation coverage. While most workers are covered, there are exceptions. For instance, employees in certain industries and independent contractors may not be covered.
  2. You did not file a report in time. There are specific timelines regarding when you must report your injury and when your employer must file a report. Failure to meet these deadlines could mean loss of benefits.
  3. Your injury is not considered work-related. To be a covered condition, you injury must have been suffered in the course or scope of your employment. If you were not on the job or if you were not performing job-related tasks, your injury may not be covered.
  4. Your injury or illness is not expected to last at least five days. This is how long a condition must last to qualify for workers’ compensation insurance.
  5. You have not submitted enough information on your condition, or you failed to see an insurance-approved doctor for an exam. Failure to comply with the medical requirements of workers’ compensation insurance can be grounds for denial.

In order to avoid these and other costly mistakes when applying for workers’ compensation benefits in Massachusetts, it can be wise to consult an attorney first. With legal guidance, you can more easily navigate the system and have confidence that your request meets the state legal requirements.


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