When workers’ compensation claims get denied, there are several common reasons given. In most cases, your denial letter will state that the claim was not filed or reported on time. There is a short statute of limitations after an injury happens for a worker to file the claim, which means that workers must take quick action to improve their chances of successfully obtaining workers’ compensation benefits.
In other cases, employers may choose to dispute your claim based on whether the accident happened at work or whether your injury or illness was truly as a result of what occurred at work.
Regardless, there are steps that you can take after a claim denial to continue to fight for the benefits you deserve. Here are some tips:
- Contact the appropriate party to discuss the denial. Before you go any farther, you can speak to your employer or your employer’s workers’ compensation insurance carrier to discuss exactly why your claim was denied. If the denial was simply due to mistaken paperwork, you should be able to clear this up easily. If your employer is disputing your claim, however, you will need to consider filing an appeal.
- File a foraml Claim. The appeals process varies from state to state, but most commonly your first level of the appeal will be to find an attorney and have the attorney file a claim and appear before an administrative law judge, through either the state labor department or a state workers’ compensation board.
- Keep thorough records. Throughout your appeal, you will need to present a variety of medical records and other factual evidence that supports your claim that your injury or illness happened due to an accident or conditions at your workplace. Make sure that you file your appeal within the time limits you have.
Do not give up your right to workers’ compensation benefits just because your claim was initially denied. There are plenty of steps that you can take to appeal initial denial decisions and get those benefits. Speak to an attorney from Gaylord Popp, LLC for more information about your legal options after a claim denial. We pledge to be your trusted legal advocate throughout the entire process of your appeal.