Getting hurt on the job is tough enough. When your workers’ compensation claim gets denied, it can just add insult to injury. Unfortunately, claim denials are a common issue for injured workers in Omaha. The good news is that an appeals process exists to help you pursue the benefits you deserve, with support available to guide you through each step.
Understanding workers’ compensation and claim denials
Workers’ compensation is insurance that provides medical benefits and wage replacement to employees injured at work. Most employers must have this coverage.
However, claims sometimes get denied. Common reasons include:
- Lack of evidence that the injury is work-related
- Missed deadlines for filing the claim
- Disputes about the severity of the injury
- Incomplete paperwork
The emotional and financial impact of a claim denial can be significant, causing stress, anxiety and financial hardship for injured workers and their families. It’s crucial to understand that a denial is not the end of the process.
What do I do after a claim denial?
Receiving a denial letter can feel defeating, but try not to lose hope: you can appeal the decision. Start by carefully reviewing the denial letter to understand the specific reasons for the decision. Identify any points you can challenge with additional evidence, like witness statements or more detailed medical records.
Do not wait when it comes to pursuing an appeal. In Nebraska, you must file your appeal within 30 days of the first judge’s decision. In other words, act fast to ensure you have the best chance at a more satisfactory outcome.
The appeals process at a glance
The appeals process can seem complex, but understanding it will help you prepare. Generally, when you appeal a workers’ comp denial, you will:
- File a formal appeal with the workers’ compensation board
- Attend a hearing with an administrative law judge
- Present evidence and testimony to support your claim
- Receive a decision on your appeal
Legal representation is invaluable during this process. An experienced lawyer can assist you in preparing your appeal, representing you at the hearing and advocating on your behalf.
You have rights as an injured worker in Omaha. Don’t let a workers’ compensation claim denial stop you from getting the benefits you need.