Workers Comp Claim Denied: What Are My Options?

The workers compensation insurance system has many benefits for both workers and employers. For starters, it helps to ensure employers do not get financially crippled as a result of lawsuits arising from work-related injuries sustained by their employees. On the other hand, it ensures that employees get compensated for any injuries they may sustain at the workplace.

Workers comp insurance usually provides wage replacement benefits as well as medical benefits to injured workers. However, there are strict deadlines for reporting injuries and filing claims. If injuries are reported outside these deadlines, a claim may be denied.

Another common reason why a claim may be denied is a dispute on whether the injury was work-related. If the injury or condition you have developed does not meet the state guidelines for workers comp insurance coverage, your claim may be denied. Another reason for denial of the claim is that you may have left your job, or you were not properly covered under workers comp system. Whatever the reason for denial of your claim, you should know that you have options.

What Are My Options?

After receiving your claim for benefits, the insurance company has twenty-one days to process your and respond to your claim. They can either approve your claim and notify you of the same, or they can deny your claim for any reason. In case of a denial, you will receive the notice of denial within twenty-one days. The notice will clearly state the reasons for the denial. The notice of denial will also invite you to appeal the decision if you think it was not warranted.

By submitting additional paperwork together with your appeal to address the reason stated for the denial, you can easily win the appeal and start receiving workers comp benefits immediately. Ideally, you should hire a competent workers comp lawyer, such as Ricci Law Firm, to help with the appeal. This will help to boost your chances of getting a desirable outcome. The workers comp lawyer will also help to explain all your rights under the workers comp system and define any legal jargon.

If your appeal is rejected, you still have options. After all, you can file another appeal with a higher authority. You can even sue your employer for your injuries, if the denial of claim is due to the fault of your employer. For instance, if your employer failed to enroll you to the workers comp system, you can sue them for all your injuries. As you can see, you should not lose hope after denial of claim because you have many options. By consulting a competent workers comp lawyer, you can be assured of getting the desired outcomes.