Receiving notice that your workers’ compensation claim has been delayed or denied can be one of the most disappointing and disheartening moments in an already difficult time. If you are going through the process, you have more than likely been through more trouble than you had imagined it would take, and now it may seem like it has all been for nothing. However, it is important to realize that a denial letter is not the end of the road, and there are still steps you can take to help your claim be approved.
Most people do not fully understand the workers’ compensation application process, because it is something they never imagine they will have to go through. To the average person, the idea of workers’ compensation seems like an obscure safety net that you will never actually need. However, if you are injured on the job, the idea becomes an all too real necessity, and you may feel like you need a crash course. Unfortunately, the insurance companies and claims workers find faults and flaws in applications for a living, and it is their job to find a basis for denial.
Reasons why workers’ compensation claims are denied
Although there is a nearly unlimited number of reasons why claims can be reasonalbly denied, there are some specific ones that claims workers watch for and cause most applicants to be delayed or denied. The most common of these is that the claim was not filed on time. Legally, claims must be reported immediately, even in a matter of days in many cases. Both the employee and employer must report the claim just as quickly for it to be approved.
The second most common basis for denial comes from disputes by the employer. For whatever reason, the company may dispute that your injury is legitimate or that it actually occurred at the workplace. This would force the applicant to gather further information and evidence, beyond the usual requirements.
These are just the two most common reasons claims are denied, and there are hundreds of others including clerical errors, unverified information, severity of the condition and many more. If you have already been denied, the denial letter should list the basis for it.
A qualified compensation attorney can help you with the initial filing or even after you have been denied. They specialize in the ins and outs of this process and are fully equipped to guide you through the process. An attorney will be aware of the “red flags” claims workers look for and help you clear these from your appeal. He or she will know what needs to be done and do the work for you so you can focus on getting healthy.