If you have been injured in a work-related accident, filed a workers' comp claim and have been subsequently denied, don't give up. While it can be difficult to persevere with your claim while being injured, possibly out of work, and dealing with your medical expenses, it could be worth your time. There are several reasons for being turned down for workers' compensation, but many of them are easily remedied, so read on to find out some common reasons to be turned down and how to deal with the denials.
Common Denial Reasons
The workers' compensation board or your employer's insurance company will inform you in writing of your denial and the reason(s). Oftentimes, the employer denies that your injury occurred in the course of your work, or asserts that the injury is not serious. You should understand that minor injuries that can be handled with a first aid kit are not eligible for workers' comp coverage. To refute these denials, make sure that you have received medical care and that you can provide proof of your medical condition and expenses. Additionally, ensure that you can provide more evidence of your injury with witnesses.
Most states have guidelines in place for filing an accident report for workers' comp claims, and each state has it's own rules. Additionally, federal jobs have their own specific rules and deadlines. You must have adhered to your state's filing deadline to be eligible for a claim. The main exception to filing deadlines is an injury that occurred gradually over time. For example, carpal tunnel syndrome is a repetitive motion injury that can sometimes take years to fully develop into an injury that prevents you from doing your job.
How To Handle Denials
Many times, the reason for the denial can be handled immediately. Carefully review the letter and determine if the reason for the denial is related to a typographical error, a misunderstanding or some other accidental omission. These minor issues can sometimes be cleared up with a quick phone call to the insurance carrier, resulting in your claim being reinstated.
Review your letter carefully also for information about filing an appeal to the denial. Pay special attention to the filing deadlines; sometimes you only have a few weeks to file your appeal. Though it varies by state, many states will allow you to argue your claim before an appeals board or at an administrative hearing. Be prepared with your medical evidence (your medical records). If you are turned down for your appeal, you may still have options to take your case to additional levels of hearings, so don't be discouraged and give up.
The initial denial letter should be taken as a sign that you may need to consider hiring a workers' compensation lawyer to help you get the benefits that you are entitled to receive.
For professional legal help, contact a law firm such as Shoap Law Offices.