It is not uncommon for an insurance company to deny a person’s workers’ compensation claim, even when the claim is valid. If you have recently filed for workers’ compensation benefits and your claim was denied, do not allow the initial denial turn you away. As an injured worker, you have the legal right to challenge a claim denial and continue pursuing your case.
Even when some workers’ are initially denied, they are sometimes approved for benefits after making the adequate changes to their petition form. The following information highlighted in this article will help you identify under what reasons your claim may be denied. Knowing and understanding common reasons to a claim denial can help you as you first petition for benefits. They can also help you understand what should be changed, altered, or added when the claim has been rejected.
Correcting a Mistake on a Workers’ Compensation Claim
Filing a workers’ compensation claim is not always easy, especially if it is the first time a worker has ever found his or herself filing for benefits. If you are filing for workers’ compensation benefits and have made a mistake in the application, your claim could be denied. Common reasons behind a claim denial could involve, but are not limited to:
Not reporting the injury straightaway or missing deadlines – If you fail to report your injury or the accident to the appropriate workplace supervisor, you could lose your right to workers’ compensation benefits. In the State of California, you have to report the injury within 30 days of when the injury occurred.
There are illnesses or work injuries that do not manifest until after the 30 day period, however. In these situations, your deadline will not begin until the date you should have known that the medical ailment was work related.
Incorrect completion of the forms – You will need to ensure that your claim is filed thoroughly and correctly.
Failing to attach the necessary medical or accident reports – When you obtain medical care, be sure to attach your medical records to your application. You can also add accident reports obtain from your workplace.
Failing to take necessary medical exams – One of the primary reasons why a workers’ compensation claim is denied is that the worker did not continue with his or her medical treatments. If you have been injured at work, you need to make sure that you continue with your medical treatments and take the necessary medical exams. Failing to do this can put a red-flag on your case, making it seem like you do not care about your injury or that your injury does not affect your ability to work.
Obtain the Legal Support of a Qualified Workers’ Compensation Attorney
There are a multitude of reasons why a workers’ compensation claim may be rejected. Although this article served to underline some of the most common reasons behind application denials, your application could be denied based on other complex factors.
You can seek the legal advice of a professional attorney if you have found that your case was rejected based on other reasons. If you are filing for the first time, it could also be helpful to seek legal advice as this can help to ensure that your application is approved straightaway.
Attorney Albert E. Hirst is a dedicated attorney who has many years of experience in handling workers’ compensation claim denials. His experience and dedication have both lead to many successful workers’ compensation claims.