Steps To Take If Your Workers Compensation Claim Is Denied

Workers compensation insurance is a type of insurance policy designed to protect employees if they are injured on the job. If you are hurt at work, you will need to file a workers compensation claim and submit the required documents. In most cases, this is an easy process and the claim will be approved. Unfortunately, there are times where a workers comp claim can be denied by the insurance company that your employer buys its policy from. If your workers compensation claim has been denied, take the following steps:

Know Why Your Claim was Denied

In the event that your workers comp claim was denied, you will receive a letter from the insurance company. Read the letter in its entirety, since the reason for your denial should be listed. There are a number of reasons that workers compensation claims are denied, such as failure to report the injury in time, not filing the claim in time, failure to seek medical treatment, and employer disputes the injury as being work related.

Contact the Insurance Company

If you know that you reported your injury promptly to a supervisor and provided the correct documentation when submitting your claim, it is worth your time to call the insurance company after you receive the letter saying that your claim was denied. It is possible that a denial could be the result of a clerical error, or an important piece of documentation needed for your claim could have been lost. The insurance company can review your claim and see if a mistake was made.

Hire an Attorney

When the insurance company is not able to help you or reverse your claim denial, you should consult a workers compensation attorney. Your lawyer will be able to review your claim and ensure that it was completed correctly and submitted on time. After that is established, your attorney can contact the insurance company on your behalf. Insurance companies may work to resolve the issue if they know that an attorney is involved. 

File an Appeal

When all else fails, your attorney can file a workers comp appeal on your behalf. Most states have strict deadlines for workers comp appeals-- your attorney can help ensure that all of your appeal paperwork is submitted on time. Provide your attorney with all of the documentation and evidence that you have, including medical records, time cards showing that you were on the clock when the injury occurred, and an incident report filled out by your supervisor, since this information will play an important role in your appeal hearing.