The insurance industry didn’t become what it is today because they pay out every claim that is filed, and that’s certainly true when it comes to work injuries and workers’ compensation. According to some estimates, roughly 1 in 4 workers’ compensation claims are denied at first, and that percentage skyrockets for certain types of injuries. One such injury is the hernia.
It’s very likely that your job duties directly caused your hernia to develop, but that doesn’t mean the insurance company will see it that way. Similar to conditions like arthritis, carpal tunnel syndrome or hearing loss, these issues are much more common in older adults and can be brought upon by outside factors or the natural aging process. Pinning these specific injuries on your job duties and getting an insurance company to agree to it will be an uphill battle, and you’ll want an attorney by your side if you’ll be pursuing workers’ compensation related to hernia development.
Hernias And Injury Compensation
If you work manual labor and you regularly squat, bend, lift or put strain on your hips and core, it’s very likely that your work duties directly contributed to your hernia onset. You went to work, bent over, lifted that piece of equipment and felt a twinge around your pelvic area. After heading to the doctor and being examined, you’re diagnosed with a hernia and surgery is scheduled. Simple enough to earn a workers’ compensation award for this, right?
Wrong.
We can all but guarantee that the insurance company won’t see it that way, and they’ll push back on your claim. They are going to review your health history, look into your daily life and learn everything they can about you in order to establish reasonable credibility for issuing a denial, including:
- Claiming that your smoking habits weakened organ tissue and led to coughing fits that caused or exacerbated the hernia.
- Arguing that hernia onset is a product of other life habits, like playing with your children or years of stress as a recreational downhill skier.
- Claiming its onset is simply a natural result of aging.
- Denying by stating that the hernia onset was the result of a pre-existing injury or other health issue, like constipation contributing to excessive organ strain.
- Tying the hernia onset to weight gain.
Needless to say, the insurance company is going to look for any reason to deny your initial claim, and they hope that you’ll get that denial and just move on. They did enough to at least cover their tracks and create a plausible reason for denying your claim, but that doesn’t mean they are right.
To lower your chances of receiving an initial denial, or to counter a likely claim denial for a hernia injury, the smartest move is to sync up with an injury attorney very early in the process. We can listen to your story, analyze your work duties, review security footage, lean on doctor exam notes and build a comprehensive claim that either earns approval or overcomes challenges made by the insurance company. If they still want to deny your claim, we’ll fight your appeal before a workers’ compensation judge. The insurance company will have attorneys on their side during this hearing, and you’ll need one by your side if you want any chance of winning. We’ve taken on the insurance companies for countless clients in the past and came out successful, and we can do the same for you.
Hernias and other injuries that can be commonly tied to aging and natural bodily degeneration can be very difficult injury claims to win, but we love and challenge and want to help you get the justice you deserve. If you’ve been diagnosed with a hernia and want to see if you are eligible for injury benefits or compensation for medical expenses tied to the injury, connect with Dean and the team at Margolis Law Firm. Give our team a call today at (952) 230-2700.
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