Three Things You Should Do If Your Workers' Compensation Is Denied
If your workers' compensation claim is denied, it may have come as a surprise to you. The most important thing to understand is that you have a right to an appeal. However, there are a few steps you need to take before you attempt an appeal. The following are the most important things you should do.
Read the letter that denies your claim
You will receive a letter from the insurance company stating the reason your compensation claim has been denied. There are many reasons why you might receive a denial of your claim. It could be that your medical treatment didn't indicate a serious injury, or perhaps your employer may not believe that you were injured at work or that although you were injured during working hours, it did not relate directly to your job. The letter may be clear, but just as often, it can seem generalized or confusing. This leads to your next step.
Get clarification about your denial
You should contact the insurance company for the specifics of your denied claim. It is possible that it was a mistake and your claim should have been approved. But it is more common for the claim to have been submitted incorrectly or with insufficient documentation. If this is the case, you may be able to submit the claim again. If the insurance company tells you that it was your employer who denied the claim, then you need to speak to the human resources department of your company.
Consult with an attorney about an appeal
Once you have exhausted all of the possibilities for reversing your denied claim, such as errors in your application or missing documentation, your next step is an appeal. Be aware that there is a time limit for your appeal. Each state is different, but the clock is ticking, so you don't want to wait. The letter from the insurance company may have a deadline for an appeal listed, but it is best to get this information from an attorney. Gather together all of the information about your injury, including medical records, and take it and the letter denying your claim to a law firm like Bishop Dorfman Kroupa & Bishop PC.
Keep in mind that once you're denied your claim for workers' compensation, it doesn't have to end there. Keep the information above in mind, and remember that once your problem is in the hands of an attorney, there may be many options open to you. For example, your attorney may want you to visit a doctor for another opinion or for better documentation of your injury. All of this takes time, so you need to move quickly so you don't miss the deadline for your appeal.