If you have suffered an injury at work, you are eligible to pursue a workers’ compensation claim. This claim must be filed in a timely fashion and you must complete all the required paperwork and provide the supporting documentation.
Unfortunately, there are many legitimate workers’ compensation claims that are denied. When you are denied workers’ compensation benefits, you will need to file an appeal.
Because of the complexity of the appeals process, you will need the help of a workers’ compensation attorney. With the help of workplace injury lawyer, your odds of winning your appeal and accessing the benefits that you need increase significantly.
Why Are Workers’ Compensation Claims Denied?
There are several reasons for workers’ compensation claims to be denied. If your claim is denied, you need to understand why and determine the best way to correct the problem. When a claim is denied, there is a denial letter sent that explains why your claim wasn’t approved.
You might be denied benefits because you weren’t eligible because your injury occurred when you weren’t at work. If you believe you are eligible for benefits, you can appeal the denial. Here are a few common reasons for workers’ comp claims to be denied:
- Failure to report the injury in a timely manner. This varies from one state to another, but as an example, in Colorado you must notify your employer in writing within four days of being injured.
- Claim wasn’t filed in a timely manner. Usually, you have 30 to 90 days after the accident to file a claim. This time limit is based on state laws.
- The employer is disputing the claim – they might allege it didn’t happen at work or was caused by horseplay rather than a workplace accident.
- The injury isn’t compensable. It is difficult to prove a stress-related injury in most states, so it might be more difficult to show it was work-related.
- No medical treatment was received. In order to be eligible for benefits, you must seek medical care.
- There isn’t adequate evidence to prove that you were hurt on the job. In this case, additional evidence and another medical examination might be enough to support your claim.
Appealing a Workers’ Compensation Claim Denial
If you have been notified that your claim has been denied, you can appeal the decision if you disagree. The denial letter will contain the specifics about how to appeal, including the time limit for filing an appeal based on state laws where you are located. Sometimes the issue can be resolved easily because of a clerical mistake or a simple misunderstanding.
Consult With a Personal Injury Lawyer
If you have been injured at work and you are pursuing workers’ compensation benefits, you should consult with a workers’ compensation attorney, especially if your claim has been denied.
Because the majority of workers’ compensation attorney’s work on a contingency fee basis, you will not need to pay the lawyer unless you win. Complete the Free Case Evaluation Form on this page so an attorney in your area can review the details of your case.