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Were You Denied Workers' Compensation?

Submitted by rsg on Thu, 04/30/2020 - 12:43

If you were injured at work, it’s likely that you decided to file a claim for workers’ compensation. This compensation can then be used to help pay for the new medical costs you may be facing after the workplace accident.

Filing a claim does not mean you are guaranteed compensation. Your claim will need to be approved before you can begin receiving compensation for your workplace injury. There are a variety of reasons workers’ compensation can be denied. Depending on the reason, you may still be able to file an appeal.

Why Was I Denied Workers’ Compensation?

Workers’ compensation claims are denied for different reasons. Some common reasons are that claims are denied include:

  • Not enough medial documentation
  • Lack of evidence proving the injury occurred at work
  • The injury was not promptly reported to the employer
  • There was no medical treatment by an approved medical provider
  • The injury isn’t covered by workers’ compensation
  • The injury did not occur at work
  • Claim was filed too late
  • The injury was the employee’s fault
  • The injury was preexisting

To help increase your chances of being approved, gather as much supporting evidence as you can. An important part of you claim is demonstrating that your injury happened while you were working, was not due to your own negligence, that the injury is serious and that it was not preexisting. By proving all of these things, your chances of approval may go up.

Ask your employer or your workers’ compensation insurance provider for a list of approved doctors or medical providers. You will need to make an appointment and receive medical care from this doctor, even if you have already done so with your own doctor.

What Can I Do If I was Denied Workers’ Compensation?

When you are denied workers’ compensation, you should receive a denial letter. The letter may include why your claim was denied. It may be that the claim was denied because of a misunderstanding. If this has happened to you, you should speak with your employer’s workers’ compensation insurance provider about the denial of your claim.

If the problem is not resolved from this, you can file an appeal and request a hearing. The denial letter may include specific instructions on filing an appeal and well as a deadline for when you must file the claim by. Follow these instructions closely when you are filing your appeal.

Appealing Your Workers’ Compensation Denial

As you are going through the appeals process, you’ll likely need to present evidence for your claim in front of a judge, labor department and/or workers’ compensation state board. If you still do not have the proper evidence to support your claim, then your appeal may be denied again.

Gather evidence to support that your injury occurred at work. This can include witness statements, video footage, picture of the accident and work logs. To show the extent of your injuries, you may want to make copies of your medical invoices, diagnosis notes, any test results or x-rays, etc.

Getting Help For Your Appeal

Appeals can be complex. There may be different phases you have to go through for your appeal. Working with a workers’ compensation lawyer can help make the appeal process easier for you.

Your attorney can help you gather your supporting documentation, present the information and negotiate with the insurance company. To have the details of your claim looked over by a workers’ compensation attorney that takes cases in your area, complete the Free Case Evaluation above today!

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