Transcript:
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The most common reason that a workers’ compensation claim gets denied is because the injured worker has a significant pre-existing or pre-injury history.
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So if an injured worker has hurt the same body part in the past or has been in treatment for that same body part in the past, that’s typically the number one reason that we see denials. Right off the bat, I would say that denials come into place if the insurance company requests medical records and there’s no reference to a work injury in that initial medical record. That tends to prompt a denial.
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Additionally, if there was a or is an employer witness or some sort of understanding that this person may not be telling the truth or something of that nature, then we can see a denial. But overwhelmingly, the number one reason we see denials are because of a significant pre-injury history involving the same body part.
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