What to Do If Your Workers Compensation Claim Is Denied
Workers compensation is something people seldom need. In fact, most workers won’t ever suffer a job related injury, and need to file a claim. However, when it happens, then it’s usually a serious issue. An accident occurs and you risk being without salary for a while, plus medical bills, so you always want your claim to be processed quickly. But not all claims are honored. What do you do if your workers’ compensation claim is denied?
The first thing to do is to look at the denial paper. Typically when you get the result, a report will be sent to you that explains how the review process went, and the reasons for rejection. In some cases, it may be a simple error, like you didn’t fill in the form properly, or didn’t include all the documents that were requested. In these cases, it may be possible to correct the issue quickly, and resubmit the paperwork. If not, then the next step to think about is an appeal. You can always appeal your rejection, and they will need to review the claim again. It may be that whoever reviewed your claim didn’t read everything correctly and made a mistake. Perhaps you actually weren’t covered, in which case they will deny it again. But sometimes, valid claims are denied simply because the employer doesn’t want to pay.
If your appeal doesn’t work, and you’re sure that you should be covered for what happened, then you may need to get a workers’ compensation attorney. These professionals specialize in cases of workers’ compensation, and a good attorney will know what to do, and whether the company should be sued. This can result in fairly lengthy proceedings, so you need to make sure you get an attorney as soon as the claim is denied. There are deadlines for both appeals and legal proceedings, and you need to be aware of them. An attorney isn’t free, but they will often review your case for free. Then, you can go in front of a workers’ compensation judge, and get your hearing, where he or she will decide who is right. This can cost you, but fortunately it’s a fairly streamlined system, unlike more traditional courts, where costs can quickly become astronomical. In most cases here you won’t have to pay all that much.
The important thing when you find out you were denied is to not panic, and read everything carefully. You have rights, such as the appeal and the hearing, as long as you follow the rules, make valid claims, and follow the limit dates. It’s worth going as far as you can if you think your employer isn’t being reasonable, because the financial aid from workers’ compensation can be quite high, and a lot of money may be in play.