My claim for workers' compensation was denied. What should I do?
UPDATED: February 20, 2013
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Appeal. Though the reasons for the denial of your workers comp will affect your ultimate likelihood of winning, your appeal should be the next thing on your agenda at this point. Any plan of action should be geared toward making the appeal happen, and making it succeed.
Steps to Take
Find out the reasons for the denial as best you can. The document you received stating that you are denied will be your best initial source of information. Sometimes denials happen for reasons that can be explained or taken care of without the need to go through the extensive process that appeals typically entail.
For instance, maybe you didn’t fill out a workers comp claims form correctly. The forms required for a valid workers comp claim vary on a state-to-state basis, and sometimes even within one particular state, there can be more than one type of form that must be filed. Perhaps your injury was not properly documented on the form, or your doctor did not fill out the paperwork in a way that was useful or meaningful for the workers comp insurance carrier. There are many types of errors that can occur –be sure you weren’t thwarted by one of those before you break out the big guns (i.e. – your attorney).
The Big Guns
Of course, valid workers comp claims are denied very frequently – processing errors aren’t to blame for all of those denials. Sometimes it takes more than fixing a form for a valid claim to be heard and paid. Sometimes, an employer or insurance carrier simply doesn’t want to pay. If you suspect this is the case for you, you should seriously consider hiring a workers compensation attorney to represent your case.
The fact is that you have the right to a hearing before a workers’ compensation judge. Read the document that says you are denied benefits carefully, and watch for deadlines by which you must appeal the denial. Considering the complexity of most workers’ compensation systems, and the fact that an experienced attorney will be defending the claim on behalf of your employer’s insurance company, it is a good idea to hire an experienced and competent workers' compensation attorney as soon as your benefits are denied.
Most workers’ compensation attorneys will offer a free initial consultation to discuss your claim and help you decide how to proceed. The key is to make the decision to hire an attorney quickly. Legal deadlines arrive faster than you might believe.