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What you can do if you receive a workers’ compensation denial

On Behalf of | Dec 27, 2022 | blog, workers' compensation

In 2021, 5,190 individuals died from work-related injuries, while 2,607,900 individuals experienced injuries from accidents on the job. Workers’ compensation is set up so that you can receive compensation for medical bills, lost wages and other expenses after an injury.

Although the process of getting adequate workers’ compensation should be easy, you are likely to receive a claim denial. This is what you can do if the insurance company denies your claim.

Review your case documents

Your first step should be to review all the documents you submitted to the documents you submitted with your claim. Look over your claim paperwork carefully. Search for errors, missing information or unclear writing.

Contact the insurance company

Next, contact the insurance company for clarification about your denial. You may receive a denial for not getting medical care, missing your filing deadlines, working under the influence at the time of the accident or leaving your job.

In addition, states have very specific guidelines, and if your injury does not fall within them, you may receive a denial. Also, your employer could dispute your claim. Some stress-related, repetitive-action and emotional injuries may not receive compensation either.

Gather additional information

You may need to prove that the injury occurred at work, so gather your initial report and claim filing documents. Get witness statements and contact information as well as any photo or video evidence of the scene. Gather your medical records, expense reports and receipts and any other evidence relevant to your treatment or injury.

File an appeal

Next, file an appeal within the required timeline, typically 30 days. The state board of workers’ compensation or labor board will hold a hearing, and an administrative law judge will make the final decision.

Workers’ compensation appeals are typically complicated. Therefore, prepare to defend your case.