Common Denial Tactics and How to Fight Back for the Benefits You Deserve
In Mississippi, a significant number of valid workers’ compensation claims fail to result in benefits. This is not because the injuries aren’t real, but because the system is built with roadblocks that favor employers and insurance companies. A state report found that the number of contested claims has risen dramatically since the 1970s, when about 8% of claims were contested.
In 2023, almost 25% of Mississippi workers’ comp claims were challenged, or “controverted.” That’s 2,315 work injuries fighting for the compensation they deserve.
Industries that filed the most workers’ compensation claims due to injuries and illnesses that year include manufacturing, retail, service industries, transportation, construction, and wholesale/warehousing.
Even among workers with clear medical documentation, claims were denied for minor technicalities or vague allegations of fault. For someone hurt at a poultry processing plant in Scott County, on a construction site in Jackson, or behind the wheel of a delivery van near Ridgeland, these denials can feel personal. However, they often follow a familiar pattern.
Insurance companies are trained to look for reasons to reject claims, not to help injured workers recover. They use broad rules, cherry-picked facts, and procedural delays to deny benefits even when the law clearly states that the worker should qualify. Understanding the most common denial tactics is one of the best ways to protect your rights.
Why Workers’ Compensation Claims are Denied in Mississippi
Workers in Mississippi industries, such as construction, warehousing, agriculture, and healthcare, often face unsafe working conditions. But even when the injury is clearly work-related, insurance companies may try to deny the claim. Here are some of the most common justifications, along with why they may not always be valid.
Injury Wasn’t Reported on Time
Mississippi law requires that a worker notify their employer within 30 days of an injury. However, many workers are unaware that this deadline begins ticking even if they are not yet aware of the severity of the injury. For example, a warehouse employee in Jackson might tweak their back while lifting inventory and try to work through the pain, only to need surgery weeks later. Insurers may argue that the delay in reporting is a reason to deny the claim, but a skilled attorney can often demonstrate that the injury was reported as soon as its seriousness was recognized.
Claimed the Injury Isn’t Covered
Insurers sometimes argue that certain injuries, like repetitive stress injuries, gradual-onset back pain, or workplace aggravation of pre-existing conditions, aren’t eligible. However, Mississippi law does allow compensation for injuries that develop over time or worsen existing medical conditions, especially if the job significantly contributed to the condition. For example, a nurse at a Ridgeland rehabilitation center who develops shoulder damage from constant patient transfers may still have a strong claim even without a specific incident.
Lack of Medical Evidence
One of the most common reasons for denial is “not enough evidence.” This might mean an insurance adjuster claims there’s no diagnostic imaging, no specialist review, or no connection between the injury and the job. But the real issue is often delay tactics or bad-faith evaluations. Many workers are sent to company doctors who minimize the injury, ignore complaints, or attribute symptoms to aging or weight. These denials can often be overcome with second opinions, detailed medical records, and consistent tracking of symptoms.
The Injury Happened Off the Clock
Injuries that occur just before or after a shift are frequently challenged. A retail worker in Flowood who slips in the stockroom while grabbing their apron may be told they weren’t on the clock, so the claim doesn’t count. However, Mississippi case law recognizes that workers are still covered in many scenarios, especially when they are performing a task related to their job or on company property. These cases often come down to specific details and how the incident is documented.
Injury Was Caused by Horseplay or Misconduct
When workers are injured in unexpected ways, such as during a break, while helping a coworker with an unscheduled task, or even during casual conversation, employers may try to shift blame. If a mechanic in a Jackson repair shop falls off a lift while hurrying to correct a mistake, the insurer might argue that the worker was careless. However, as long as the worker was acting within the scope of their employment, benefits may still be applicable. Legal assistance is often necessary to counter these vague accusations.
It Was a Pre-Existing Condition
This is one of the most frustrating denials for older workers or those in physically demanding jobs, such as roofing, farming, or industrial work. Insurance companies argue that pain or limitations are due to age or a previous injury, not the job. But Mississippi law allows compensation when work aggravates or accelerates a pre-existing condition. This is something insurers often leave out when denying claims.
You Were Off the Clock
Injuries that happen before a shift starts, after it ends, or during unpaid breaks may be challenged as “not compensable.” For example, a hotel cleaner who slips in the parking lot or a restaurant worker who lifts heavy boxes before clocking in could still be eligible for benefits. Denials based on clock status can often be overcome with legal help.
You Were Cleared to Work
Sometimes, a company-chosen doctor will declare a worker fit for duty when they’re clearly still in pain. This often happens in retail, manufacturing, and healthcare settings, where employers need staff back quickly. Returning to work doesn’t automatically mean the injury is healed, and returning too soon can worsen the condition.
You Didn’t Follow the Right Process
Mississippi’s system requires injured workers to follow specific procedures, including using approved doctors and reporting updates. But these rules aren’t always explained clearly. Workers who fail to follow an internal policy, miss a form, or rely on verbal promises may have their claim denied without realizing they did anything wrong.
Each of these tactics creates unnecessary hurdles for injured workers across Mississippi. In too many cases, claims are denied not because they’re invalid, but because the process is designed to favor the employer and insurer.
That’s why legal guidance is more than just helpful. A workers’ compensation appeals attorney familiar with Mississippi law can challenge these denials, demand proper documentation, and make sure the worker’s voice is heard.
A Workers’ Compensation Lawyer Can Help You Pursue the Benefits You Deserve
If your workers’ comp claim was denied or delayed, you’re not necessarily out of options. At Tabor Law Firm, P.A., we help injured workers across Mississippi stand up to unfair claim denials and fight for the full benefits they’re owed. Whether you’re just starting your claim or stuck in a battle with the insurance company, we’re ready to help.
You don’t have to figure this out on your own. Contact us today for a free consultation. Let’s get you the help you deserve.
"Jonathan and his staff were very professional and got me all the medical needs that I was entitled to. He stayed on top of my case and kept me informed all the way till the end." - Jeff N., ⭐⭐⭐⭐⭐