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What is Compensable vs Non-compensable Injuries in a Workers’ Compensation Case

If you have an accepted workers’ compensation claim, ‘compensable injury’ is something you need to know. If the insurance carrier acknowledges and accepts that you sustained a work-related injury, compensable injury is the actual injury that they have accepted and will cover medical treatment for…the rest of your life.

Non-compensable injury, are injuries they do not accept as being caused by the work-related incident. They will not cover nor pay for any medical treatment or diagnosis they have not accepted.

How do you know what injuries are covered? The carrier must file a ‘Plain Language Notice’ (PLN) form that disputes the injuries that they feel are not part of the compensable injury. You and your doctor should receive this in the event there is a dispute over what injuries are compensable(accepted) or non-compensable (disputed).

The carrier will often accept a strain/sprain but deny that a tear or a herniated disc is not related and deem it “pre-existing.” You will be appalled at the numerous reasons/times that they deny the more serious injuries! You will probably say, “Pre-existing?! I’ve NEVER had any problems with my [insert body part] in my life! How is it pre-existing!!!?”

Anytime you feel that the insurance carrier is not covering all your injuries, you need to seek assistance at once. Lifetime medical benefits are at stake and all injuries suffered from your work related accident should be made compensable.

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