How Many Workers’ Compensation Claims Are Denied Each Year?

Wooden and gold pen lies on a Work Injury Claim Form with red DECLINED stamp on it

Surprisingly, there is very little state or national data on how many workers’ compensation claims are denied. I’ve read that some insurance groups estimate first-round denial rates to be as high as 25%, but there doesn’t appear to be any accessible and reliable studies on the subject.

At our firm, we handle denied claims because we understand that far too often some insurance companies deny valid claims. We are upfront with potential clients and only work with individuals whom we think we can help. We have decades of combined workers’ comp case experience and know that the success rate of a workers’ compensation case is highly dependent on the circumstances surrounding it.

Instead of worrying about how many workers’ comp claims are denied, I advise you to focus on the things you can do to try to improve your chance of getting workers’ compensation benefits.

What to Do to Try to Boost Your Workers’ Comp Claim Success Chances

After you’re injured, time is of the essence. To try to maximize the likelihood of your claim being successful when you are hurt on the job, you should follow these steps:

  • Report the injury to your employer immediately (in writing if possible)
  • Have your employer send you for medical care
  • Talk to a workers’ compensation attorney
  • Record everything that happened when you were injured
  • Obtain a copy of the accident report from your employer
  • Maintain records of all communication regarding the accident and medical care
  • File a workers’ comp claim or request that your employer file a claim*

* Some states, such as South Carolina, require that the employer (rather than the employee) file the claim.

Contacting an Attorney Can Be Vital in Workers’ Compensation Cases

You’ll notice that I listed “Talk to a workers’ compensation attorney” as the third suggested item – just after reporting your injury and seeking medical care. That’s because workers’ compensation cases can quickly become complicated. There are rules and procedures that must be followed to try to ensure the greatest chance of obtaining benefits. And there are also some insurance companies and employers who may want to minimize or even avoid paying benefits.

An experienced workers’ comp attorney can help you try to deal with these factors from the start. Here’s a video that explains several of the reasons why you should consider hiring a workers’ comp attorney. But before you decide whether or not to hire an attorney, contact the Law Offices of James Scott Farrin for a free case evaluation, online or over the phone at 1-866-900-7078.

We evaluate each case carefully before signing a client because we don’t want to waste your time and energy if we think your claim can’t be supported. And if we decide to work together on your workers’ comp claim, there will be no upfront costs to you or hourly fees to worry about because we work on a contingency fee basis.2 This means that we get paid an attorney’s fee only if we are able to recover for you.

We will work with you to try to ensure your claim is handled correctly from the beginning.

Brian Clemmons

About the Author

Brian Clemmons practices workers’ compensation law in North Carolina for the Law Offices of James Scott Farrin. He was named on the 2022 “Best Lawyers”a list for Workers’ Compensation Law – Claimants by Best Lawyers in America. Brian has presented at numerous continuing legal education courses and has many decades of experience in a variety of practice areas. He also has a great deal of experience as a defense attorney for insurance firms, so he has seen personal injury law from both sides of the table.

aFor more information regarding the standards of inclusion, please visit www.bestlawyers.com.

five star review badge Former Workers’ Compensation Client, Online Google Review
I want to thank everybody who worked on my case at James Scott Farrin.

I want [to] thank everybody [who] worked on my case at James Scott Farrin. They did a very professional and great job. I would recommend them to anybody that was ever looking for a lawyer, and I definitely would use them again. 1

For legal reasons and client confidentiality, reviews have been slightly edited to remove identifying information and correct typos.