Dealing with a workplace injury can be tough, especially if your employer or their insurance company denies your claim. Knowing your rights and how to respond to a denied claim can help you get the support and compensation you deserve. What should you do in this situation?
Know the reasons for the denial.
First, figure out why your claim was denied. Common reasons include the injury not being related to work, missing the deadline to file the claim, not having enough evidence to support the injury claim or issues with your medical records. Make sure to read the denial letter carefully to understand the reasons for the denial.
Seek legal advice.
It is a good idea to talk to a lawyer who knows a lot about worker’s compensation right away. A workers’ compensation lawyer can help you understand your rights, check if the denial was justified, and advise you on what to do next. Many offer a free first meeting and only get paid if you win your case.
File a Formal Claim and litigate the matter.
If you think your employer or their insurance wrongly denied your claim, you can file a Formal Claim with the worker’s compensation board in your state, at which point it will be assigned to a Judge who will decide whether or not you are entitled to benefits. You might need to file additional evidence, (such as medical reports / opinions from doctors), and testify at a Hearing before a Judge.
Gather additional evidence to support your claim.
To make a strong case, you will need to submit evidence confirming your injury and that it was caused by your work / occurred in the course of your employment. This could include medical records, reports from your doctor, statements from people who saw the injury happen, or an expert’s opinion on how your injury is related to your job. Be sure to keep up with all medical treatment and keep detailed records of everything related to your injury and treatment.
Stay organized and be sure to meet deadlines.
It is very important to stay organized and meet all deadlines throughout the worker’s compensation process. Each State has timelines (a) to provide notice to your employer of the injury and (b) to file a Formal claim (i.e. the Statute of Limitations). Keep a detailed file of all documents related to your claim, including medical records, off work / work restriction notes, correspondence from your employer and their workers’ compensation insurance company, and any legal documents.
Facing a workers’ compensation claim denial can be a challenging hurdle, but it is crucial not to lose hope. With the right approach and resources, you can work towards overturning the denial and securing the compensation you rightfully deserve for your workplace injury.
