Every so often we hear of workers’ compensation claims that were denied on the basis that the injuries were idiopathic in nature. But what exactly does it mean to have your claim denied for idiopathic reasons, and what is your recourse if your claim is denied for this reason? We explain what idiopathic injuries are and how to counter a denial for idiopathic reasons in today’s blog.
What Is An Idiopathic Injury
An idiopathic injury is a type of injury that is unique to the individual and occurs without cause or relation to work activities. We find that it’s easier to explain this with an example. Let’s say you were walking in a hallway at work and your knee simply gave out, resulting in an injury. An insurance company may deny your claim on the basis that no work activity contributed to the injury, rather an idiopathic cause unique to the individual was the reason why their knee gave out.
It may seem like it would be difficult to argue against an idiopathic claim denial if the insurance company believes that the injury was unique to your situation, or worse, you believe it may be idiopathic yourself. However, it is astoundingly rare that an injury is truly idiopathic. Oftentimes there are underlying factors at play that absolutely justify the injury being processed as a workers’ compensation claim.
Let’s go back to that example of your knee giving out. While it may have appeared to give out, there may be other relevant factors at play. Were you hustling to get to a meeting on time? Were you wearing high heels as dictated by an expected dress code? Did you step on some liquid or a slippery spot of the tile? Did you trip going down the stairs? Did an object or frayed piece of carpet cause your fall? Were you carrying supplies and couldn’t see a potential hazard? If any of these factors are present, or if your work duties in any way influenced your fall, you no longer have an idiopathic injury, you have a workers’ compensation claim.
As you can see, developing a counterargument to an idiopathic claim denial can be complex. Not only because you have to show that a work-related cause exists, but you have to prove that it influenced your accident. That’s where a workers’ compensation lawyer like Dean Margolis comes in. Dean and the team at Margolis Law Firm have been getting clients the money they deserve for more than a decade, and they know how to frame a claim so that you can avoid a denial for idiopathic reasons. He can also help file a counterclaim in the event your initial claim is rejected by the insurance company on idiopathic grounds or for any other reasoning.
Don’t take the insurance company’s decision as full and final, because they rely on people not pursuing the true worth of their injury case. Initial denials are more common than you may imagine, and unfortunately, many people stop their case there when they should file a counterclaim through an attorney. We’ve done that for countless individuals in the past, and we’d love to do the same for you and get you the compensation you deserve.
So if you’ve been told your injuries are idiopathic, or you just want help putting together the strongest case to get yourself the biggest award possible, pick up the phone and give Dean and the team at Margolis Law Firm a call today at (952) 230-2700. We’ll go to bat for you and we won’t stop until we have helped you achieve a satisfactory outcome. For more information or to talk to an attorney about your case, contact us today.
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