Claim problem

Employer Says Injury Is Not Work Related

Use this scenario page to organize the paperwork and questions connected to causation, job duties, medical history, and witness statements.

Start with the issue actually in dispute

Insurer says injury is not work-related is mainly a problem of causation evidence. Build the file around the written notice, dated record, or event that created the problem.

Documents to gather

Incident or exposure record, medical opinion, prior history, job duties, witness information, and denial letter.

Questions to answer before acting

  • What changed, on what date, and who made the decision?
  • Is there a written notice or only a phone conversation?
  • Which medical, wage, employment, or incident record directly addresses the dispute?
  • What state or federal agency procedure controls the next step?
  • Is there a separate employment, third-party, leave, or discrimination issue that should not be mixed into the workers’ compensation question?

Important caution

Focus on the stated causation dispute and what evidence addresses it.