The Lengths to Which Workers’ Compensation Insurance Companies Will Go to Deny a Claim

It often seems like a workers’ compensation claim should be simple—you were hurt at work, you have witnesses, you even have a medical opinion. But here’s what you need to understand–workers’ compensation insurance companies have a vested interest in paying as little as possible to settle your claim—so does your employer.

Workers’ compensation insurance companies make their money by maximizing premiums and minimizing payouts—it’s that simple. So they’ll look for any opportunity to deny your claim and they’ll use their size and financial resources to make you keep fighting. Your employer’s workers’ compensation premiums are based, in part, on the number of claims the insurance company has to pay on their behalf. The more claims, the higher the premium, so you can see the incentive to reject your claim.

One of the classic strategies workers’ compensation insurance companies and employers use to delay or deny benefits is to allege that the injury was the result of a prior injury or pre-existing condition. They’ll look for anything to shift the blame. Here’s an example from our case files:

We represented a woman, a college graduate, who worked in the cosmetics industry. She suffered an injury lifting some boxes at work, but the workers’ compensation insurance company denied her claim, even though there were witnesses and there was a medical opinion. When we looked into it, we discovered that the insurance company was alleging that the injury was caused by a motor vehicle accident our client had been in before she started work for the company. Our investigation indicated that she had been in an automobile accident, but it was when she was 13, and that she had received treatment for it. Evidence also showed that she’d been a regular member at a fitness center, so the injury from the car crash had totally healed. We were able to get her the benefits she needed and deserved.

The Lengths to Which Workers’ Compensation Insurance Companies Will Go To Deny a Claim

Experienced NYC | Queens | Bronx | Brooklyn Workers’ Compensation Lawyers

At Pyrros & Serres LLP, we provide comprehensive counsel to people with workers’ compensation and Social Security disability claims in Brooklyn, Queens, the Bronx and across the greater New York City metropolitan area. Because of our reputation for effective advocacy, many of our new clients come to us as referrals from clients and other lawyers.

To learn more about the full scope of our practice, see our practice area overview page.

Pyrros & Serres LLP

Queens | NYC | Brooklyn | Bronx Workers’ Compensation Attorneys