Denied: Taking Action After Your Workers' Comp Denial

Posted on

If you have been injured at work, you deserve certain benefits. Work-related injuries usually mean that workers will have their medical bills paid for as well as other benefits. Even if you've got a illegitimate workplace injury and have filed your claim form, you may end up with a letter of denial. Read on to learn how to take action when this happens.

The Denial Letter

Your denial will come in the form of a letter, and that letter should contain a lot of useful information about the reason for the denial and what your rights are to an appeal. Often, you have only a certain, limited amount of time to file for an appeal, so be sure to note any dates as well as the exact reason for the denial.

The Reason for the Denial

It some cases, the denial reason is a simple matter of a missing detail or incorrect information in the claim form. Make a call to your workers' comp carrier to see what might be done to remedy the issue; you may be able to file an amended claim form and get your case reinstated.

Filing an Appeal

Keeping in mind that workers' comp is run by each state individually, the appeals process can vary. In most cases, however, you will be able to plead your case about your workers' comp claim before an administrative hearing officer. This is often under the umbrella of your state's workers compensation board or department of labor. In most states, there are several levels of appeals after the administrative appeal.

Speak to an Attorney

The decision whether or not to file an appeal should be discussed with a workers' comp attorney, and you should take action as soon as you can. If you exceed the strict time limit, your opportunity to get coverage will be lost. The procedure for filing a appeal can be complex, and this is one area where mistakes are to be avoided.

Often, a appeal hearing will involve the presentation of your medical evidence regarding your injury or illness, and a complete set of medical records and all related documentation will be needed. While it may be technically possible to represent yourself at an administrative hearing, it is inadvisable. The appeals process is full is rules, evidence and civil law procedure, and you may find yourself out of your depth. The help of a workers' comp attorney could make the difference between dealing with a workplace injury on your own or winning valuable workers' comp benefits. Talk to a workers' comp attorney right away.