An injured employee’s claim for benefits may be denied if the insurance company:

  • Denies that an injury occurred on the job;
  • Accuses the employee of fraud or misrepresentation of an injury; and/or
  • Blames a worker’s injury on a preexisting condition.

If a worker’s claim is denied, they have a right to appeal the denial of benefits. Once an employee receives the denial, they can file a petition with a workers’ compensation appeals board in their state.  The process varies by state. In Florida, for example, injured workers filed with the Division of Administrative Hearings, which assigns the case to a judge who will schedule a hearing within 40 days.