What To Do When Your Workers' Compensation Claim Is Denied

Posted on: 9 May 2017

In the event of a work-related injury, your employer would process your workers' compensation claim without any hesitation. However, an opposite reality is common for many people. Even with a denial, this does not have to mean that your claim is dead. While it may be somewhat of a bump in the road, there is a path forward.

Find Out The Reason

If you receive an initial denial, your first task should be to find out the exact reason for the denial. In some instances, the reason for a denial is something more significant like non-covered injuries or even an issue with injury liability, such as the injury being the fault of the employee and not the employer.

However, in a number of cases, the reason for the denial is something more technical like missing medical records. With the latter of the two, simply supplying the missing documentation will resolve the issue and help push the claim through.

Take Action

When you get a denial, be ready to take action. This is not the time to procrastinate and wait around to determine what you need to do next. Not only will a delay with filing an appeal delay your access to any compensation you need, but you may run out of time. Most states have a maximum number of days that you can file an appeal within after your claim has been decided on, such as 30 days.

If you exceed this period and file later, your workers' compensation claim may receive a default denial, leaving you without the access to the benefits you desperately need. Often, the denial will also include appeal instructions, so don't wait around.

Reach Out To The Insurance Company

It might also be a good idea to reach out to your employer's insurance company. In some instances, if your claim was denied, your access to coverage under the employer's insurance company may be altered.

Rather than finding yourself left with unexpected bills, reaching out to the insurance company will provide you with any necessary instructions while you are waiting for your claim to be reviewed again as part of the appeal. If you already have an attorney representing you, they can handle this step for you.

Don't overlook the assistance a workers' compensation attorney can offer you. From understanding the specifics of your denial to helping you move forward with your appeal, an attorney can provide you with the help you need. 

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