Understand the Reason for Denial
When your workers' compensation claim is denied, the first step is to understand why. Common reasons include missed deadlines, insufficient medical evidence, employer disputes, or claims that the injury is not work-related. You should receive a denial letter explaining the reason. Carefully review this document to determine the next steps.
Gather Additional Evidence
If your claim was turned down because of inadequate proof, compiling extra material will help to support your case. This covers medical documents, witness accounts, accident reports, and any correspondence your company sent on the injury. A second medical opinion from another doctor may also support your claim.
File an Appeal
Most states let you contest a denied workers' compensation claim. States vary in their appeal procedures, although they usually consist of formally requesting something from the workers' compensation board. Make sure you fulfill all deadlines; failing them could cause you to lose your entitlement to benefits.
Get Legal Counsel
Should your claim be refused, a workers' compensation attorney may prove quite helpful. They can defend you at hearings, help negotiate the appeal procedure, and guarantee all required documentation is turned in. Many lawyers work on a contingency basis—that is, they only get paid should you win your case—and offer free consultations.
Go to Hearings or Mediation
Should your appeal develop, you could have to show up for a hearing or mediation. While a hearing is a more official process whereby an administrative judge evaluates evidence and determines your claim, mediation is negotiating a settlement with the insurance company. Get ready to show solid proof bolstering your argument.
Think About Additional Advantages
Should your workers' compensation claim still be dismissed, you could look at other possibilities. Alternately financial support might come from disability benefits, private insurance, or even legal action against your company. Speaking with a legal professional will help one decide the best line of action.
Remain Persistent
Your case does not end just because a claim is denied. Many employees effectively reverse denials by appealing the decision, following the correct procedures, and consulting attorneys. Learn about your rights and act to get the advantages you are due.