Denied Workers Compensation Claim: What Is The Next Step?

Getting hurt on the job can prevent you from working for a very long time, sometimes indefinitely depending on the severity of your injury. As soon as you are hurt, you should file for workers compensation insurance. There are often cases in which it takes a very long period of time before your claim is approved, and even more cases in which the initial claim is denied. The following is some information on why your claim may have been denied and what you can do:

Why Your Claim Was Denied

If your workers compensation was initially denied, there are a variety of reasons why that may have happened. It could have been something as easy as a missed deadline or missing paperwork. It is crucial to get the proper paperwork in by the designated deadline, as the law requires that both you and your employer file your claim within a certain amount of time following your injury. The employer must then report the filing to their insurance carrier. If both parties fail to provide paperwork in a timely manner, it can result in a denied claim.

You may also be in a situation in which your employer will dispute your claim. The employer can dispute your claim if they believe that your injury did not occur while on the job. If this happens to you, you are required to provide sufficient proof that your injury occurred while you were working for your employer or was caused by accidental exposure to a substance or other materials used at your job. Your evidence can include witness statements, medical records, or a deposition from an independent physician stating that your injury is job related.

What You Can Do Next

If your claim is initially denied, you can file an appeal. You should receive a denial letter with detailed information on the appeals process. Contact your human resources department to talk about the denial. If it was due to an issue with a paperwork mistake on the part of your employer, it can often be reprocessed fairly quickly. If you were responsible for the lapse in paperwork, it can be more difficult to resolve the claim with your human resources department. You will likely be required to go through the appeals process unless your employer can make an exception for your situation.

The appeals process will vary from state to state. They all typically include going before an administrative law judge. You will present your evidence during your hearing in front of the state labor department or the workers compensation board.

If you believe it will be difficult to get your claim approved, you may want to consider hiring an attorney to assist you. Your attorney will help you gather your evidence and navigate you through the difficulties that can arise during a workers compensation hearing. You can click here for more information.