WORKERS' COMP CLAIM DENIED

Employers and their insurers will occasionally look for any reason to deny workers’ compensation claims. This reason must be permitted by the law. Common reasons for claim denials include the following:

•  Missed deadlines.
•  Disputes about whether injury is work-related.
•  Your condition doesn’t meet state guidelines.
• You filed the claim after you left your job.

Do not give up your right to workers’ compensation benefits simply because your initial claim was denied. First, carefully review the letter informing you that your claim has been denied. Almost certainly, it will include the reasons for the denial. If you believe the problem was caused by erroneous paperwork or something similar, you may want to contact the claims adjuster to resolve the issue. However, this strategy is unlikely to succeed unless your employer or insurance provider admits to a genuine error. You will most likely need to consider appealing the denial.

The letter you received may contain instructions on how to appeal a denied claim. If so, carefully read it. The appeals procedure varies from state to state. Typically, the initial level of appeal is a hearing before an administrative law judge, where you must present medical and other supporting evidence for your claim. The hearing may be conducted by a state labor department or state workers’ compensation board. In addition to the initial administrative levels, there are additional levels of appeal that vary by state.

Each state has its own time limit for appealing a denied workers’ compensation claim, which is typically between 30 and 90 days. Check your denial letter or the website of your state’s workers’ compensation agency for the deadline.

Unless your claim was denied due to a simple mistake, consult a workers’ comp attorney as soon as possible. A lawyer can help you decide whether to appeal. You don’t want to lose your workers’ comp benefits because you missed a deadline. Consult the best work injury lawyer before filing a self-appeal. Appeals are complicated legal processes that require knowledge of evidence and civil procedure. If you lose early, you may not be able to submit more evidence later. Many injured workers lose their appeals because they don’t have a workers’ compensation attorney to help them.