What to Do If Your Workers’ Compensation Claim is Denied

Author: Auger Law | August 5th, 2016

If you are injured at work, you can reasonably expect that your injuries will be covered by workers’ comp. That’s what the insurance is put in place for. But what happens if you put in a claim and that claim is denied? The good news is that you still have options. Here is a brief outline of the denial of workers’ compensation claims.

Reasons for Denial

When your claim is denied, the first thing you want to do is determine why. You should reason a denial letter that tells you exactly why you were turned down for benefits. Common reasons include:

  • Timely Reporting: You did not report your injury in the time frame allotted by state law or you did not file your initial claim within the time limit.
  • Employer Dispute: Your employer may dispute your injury for a disqualifying reason (horseplay, outside the scope of employment, etc.)
  • Not Compensable: This does not argue that you were injured, but that your injury is not compensable under state law.
  • Medical Attention: You failed to seek medical attention after your injury.
  • No Evidence: There is not enough evidence to prove that your injury occurred on the job.

Appeal

If your workers’ comp claim is denied and you know the reason why, you can file an appeal. Within the letter will be a date by which the appeal must be filed. One of the first things to do before you file an appeal is to meet with your employer. In some cases, a denial is made over a simple clerical error that can be cleared up quickly. If this is not true in your case, you will want to consult an attorney.

Legal Representation

While you can certainly file an appeal on your own, an attorney experienced with workers’ compensation law can be of great value. Most attorneys offer a free initial consultation to look over your denial and advise you if it would be wise to appeal. Take advantage of this consultation. It is a waste of time to move forward if you do not stand a chance of winning.

If you need assistance with workers’ compensation in Charlotte, call our office. A member of our team will review your case at no cost to you and advise you of your options. This is true whether you are filing an initial claim or considering an appeal of denial. Call today for assistance or browse our website for more information about our firm.

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Posted In: Workers' Compensation