Workers' compensation insurance exists to protect both businesses and their employees. Specifically, a workers' compensation policy should kick in and provide reimbursement or coverage for expenses related to an employee's on-the-job injury or illness. This can include any expense from medical bills to lost wages. If you've been hurt on the job and have recently filed for workers' compensation, you may be surprised to have received a denial letter in the mail. By knowing what to do (and what not to do) following a claim denial, you can move forward with confidence.
Don't Panic
First and foremost, try not to panic or worry too much just yet. Believe it or not, many workers' compensation claims are initially denied. Often times, denials are for simple reasons, such as missing paperwork or documentation that can be easily resolved. If you receive a denial notice, don't assume that this is the end of your claim. You may still very well be entitled to compensation.
Review Your Denial Letter
By law, you are required to be provided with a letter detailing the reason for your workers' compensation claim denial, along with instructions on your options/next steps. Take the time to fully read your denial letter so you can fully understand the reason for your denial. If the reason is something simple, such as a lack of documentation, you may be able to obtain the necessary documents from your doctor or other professional and send them in to move forward with your claim.
Submit an Appeal
If the reason for your denial isn't as clear-cut as missing paperwork or an error in your application, it may be necessary to pursue things a little further by submitting a formal appeal. The process for filing a workers' compensation claim appeal can vary a bit from one state to the next, so take time to familiarize yourself with the laws in your state before moving forward.
Contact a Lawyer
If you're facing a complicated case or plan on filing a formal appeal, you need to consult with a workers' comp lawyer who handles these kinds of cases. This way, you can receive professional guidance and representation moving forward. This should ultimately give you the best chances of a successful recovery and/or appeal.
Receiving a denial letter for the workers' compensation benefits you were counting on can be stressful, but be sure to keep this information in mind as you move forward.
Share12 July 2019
When I started my first small business, I had no idea how much I really didn’t know. I was fully prepared to deal with customers, sell product and even handle complaints and returns. What I wasn’t aware of was that there is so much more to it. I was lacking the legal expertise to protect the company and myself. I wanted others to benefit from my experience, mistakes and lessons learned, so I started this blog. From employment law to the legal business contracts you’ll have to sign when you form partnerships, business law is complex. I hope that the information here will help you to be better prepared when you start your business so that you’ll know when you need to call an attorney and when you can handle things yourself.
