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When workers' compensation benefits can be denied

Most Minnesota employers are required by law to carry workers' compensation insurance to protect their employees who are injured on the job or who develop a work-related disease. However, there are some instances where the coverage can be denied.

One such circumstance is if the cause of the employee's injuries cannot be determined. For instance, if an employee suffered a stroke or a heart attack at the workplace, the condition could be due to non-work-related factors. The injured employee would have to have an independent medical exam to find the exact cause. Additionally, employees who become injured because they willfully neglected to obey the workplace rules or who participated in horseplay or were intoxicated at the worksite are likely to be denied the insurance benefits. On-the-job injuries that are self-inflicted are not compensable.

A claimant who fails to undergo an independent medical evaluation may also be denied benefits or be given a reduced amount, since these test results are necessary in order for the claim to be verified. In other cases, if evidence shows the claimant's injuries are not as restrictive in nature as the claimant first alleged, the benefits might be cut, and the claimant may be obligated to return to his or her job sooner.

In another example, coverage will likely be denied if injured workers fail to follow the required deadlines. Besides the deadline for reporting the injury to the employer, there is a statutory time period within which the claim must be filed.

Even valid workplace injury claims are sometimes denied or disputed by an employer for a variety of reasons. As a result, having the assistance of an attorney can be advisable throughout the process.

Source: FindLaw, "Common Workers' Compensation Defenses", Aug. 17, 2016

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