What Should You Do If Your Workers’ Compensation Claim Is Denied?
Workers injured in the workplace are generally compensated for their injury and losses through the workers’ compensation system. This system is a type of insurance that your employer takes out. A number of states demand that employers have workers’ compensation insurance in accordance with the average level of risk for their industry. It is not uncommon for claims to be denied, for many different reasons. Even when this happens, the injured worker still has options and routes to take.
The reasons why work comp claims get denied
When your claim gets rejected, the most natural and advisable thing to do is find out what that happened. The denial letter should contain this information. Maybe your claim was denied because you were not eligible to recover compensation, like for example in the case that your injury was sustained outside your workplace and without connection to your work duties.
The most typical reasons why work comp claims get denied are:
- Untimely reporting of the injury – There are state-specific regulations that set a deadline by which your employer has to be notified about the injury. In general, the employer should be notified in a matter of days.
- Late claim – The period within which the claim should be filed also varies from one state to another, but it generally falls in a 30 to 45 days limit.
- Disputed claim – Employers will sometimes dispute the claim by refusing to accept that the injury was sustained in the workplace or connected to work duties
- Injury cannot be compensated – Stress-related claims are generally difficult to prove
In addition to these most common scenarios, work injury claims get denied on many other grounds.
Filing an appeal
After you find out why your claim was denied, it’s possible you’ll want to appeal. There is a deadline by which you should do that and it will be stated in the denial letter. In some states this deadline is 30 days from the day you receive the letter.
Bear in mind that you should always check with your employer whether there has been a clerical error. It can happen that the letter is the result of misunderstanding or technicality.
If you want to appeal the decision, it’s most advisable to seek the help of an experienced work comp lawyer. Appeals are complicated and there are several levels of appeal. You shouldn’t hesitate to hire an aggressive, ethical and experienced workers’ compensation attorney. He or she will review your case, explain you the procedures and make the necessary preparations, as well as handle communication with your employer’s insurance company.
Get a workers’ comp attorney today
There are many workers’ compensation lawyers in your area that offer free initial consultations, in which you can get valuable information about your case and chances for success. You can only gain if you contact a work comp lawyer right away. Don’t waste precious time! Reach out to a legal professional and protect your rights!