Making The Most Of Your Money

Denied Worker's Compensation? Here Are Your Next Steps

22 July 2016 by Glen Robinson

Worker's compensation comes in handy if you're ever injured on the job and need coverage for lost earnings and medical expenses. But don't be surprised if your employer's insurance provider decides to deny your worker's compensation claim. The following not only explains why your claim could be denied, but also how you can appeal the decision and move forward with your claim.

Find Out Why

The first step towards getting the compensation you deserve is to find out why your claim was denied. In most cases, you'll receive a letter stating why your claim was initially denied. There are several reasons why your claim could be denied:

• You didn't report your injury in time. Different states have different statutes regarding how soon you should report your injury to your employer.
• You failed to file your claim within the time limit. Different states also have different deadlines for filing a workers compensation claim. In most states, you'll have 30 to 90 days to file your claim.
• Your claim is for an injury that isn't covered under state statutes. For instance, most states do not cover emotional distress or stress-related injuries.
• Your employer disputes your claim. Your employer could argue that your injuries occurred outside of work, were pre-existing or occurred due to a non-work reason (such as horseplay).
• You failed to receive medical treatment for your injury. In order to receive workers compensation benefits, you have to have your injury treated by a doctor.
• There's not enough evidence that your injury was work related. You may need to provide more medical proof of your injuries before receiving your benefits.
• There was a clerical error. Most denials caused by erroneous information or simple misunderstandings can be cleared up by speaking directly with your employer or its insurance provider.

File an Appeal

After finding out why your claim was denied, you'll want to appeal the decision to your state's labor board or worker's compensation board. In most cases, an administrative law judge will hold a hearing where both sides can argue the merits of the case. There's also a time limit for filing an appeal, so you should have this done as soon as possible. You'll also want to have an experienced worker's compensation attorney present, like McMullen & Ochs PLLC, to help you with the appeals process.

Don't Forget about Evidence

For a successful appeal, you'll want to have plenty of evidence that supports your claims. This includes an additional medical exam highlighting your injuries, time sheets to establish when you were working and eyewitness testimony from co-workers. 

Share

Search