What Should You Do When Your Worker's Compensation Is Denied?
Posted on: 4 November 2019
According to the law, employers are required to have worker's compensation coverage to protect their employees from financial ruin when they get injured at work. Assuming your company carries compensation insurance for its workers and you get injured, it is your responsibility to preserve your legal rights by taking the appropriate steps. This way, you will be compensated for lost wages, medical expenses and future complications that may occur.
First, you are required to notify the management right away about the incident. Even if you are taken to a hospital, your employer must be informed once the condition stabilises. Your employer will offer a claim form that must be filled out accurately and completely – do not be tempted to exaggerate. Make a copy of the same document and submit the original one to the employer. Someone from the insurance company should contact you after you return the claim form, and if everything checks out, you will be eligible for compensation.
Reasons the insurer may deny the worker's compensation claim
Insurance companies don't always honour the request, and this is often outlined in a denial letter. This occurs when you don't meet the set eligibility requirements. They can claim that the injury occurred as a result of a pre-existing condition, you didn't get injured while at work, you cannot prove you were injured at work (the location and time), you didn't report the injury or file the claim on time or the doctor says you weren't injured at work, among other things.
Steps to appeal the worker's compensation denial verdict
Although the steps you can take to appeal the compensation denial decision may vary from one state to another, there are some key things you can do. Do not give up if you believe your case needs to be reviewed.
First, contact the insurance company to know why they didn't pay your benefits. Perhaps you didn't file the claim form accordingly or some key documents were not attached. You might also talk to your employer, especially if they are the reason why your compensation wasn't provided, and ask them to reconsider.
If this doesn't work, consider working with a compensation lawyer. Compensation lawyers are experienced in dealing with such cases and should help you get your claim. The lawyer will assist you in filing a formal appeal to the right administrative agency before the set timeline lapses. They will also ensure you have the required documents and teach you some key things about the appeal. Though the legal process might be complex, your lawyer can help you get a favourable outcome.
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