Accidents happen. When they happen at work, many workers take comfort in knowing their employers must carry Workers’ Compensation insurance to protect them from potentially devastating medical expenses. Unfortunately for the injured worker, there is no guarantee that a claim will be approved by Workers’ Comp.
When an employee is injured on the job, the employer and employee follow procedures to file a claim with the insurance company that provides that company’s Workers’ Comp policy. The insurance company receives the claim and issues a decision to approve or deny based upon all information provided by the employee, employer and medical professionals. Reasons for a denial vary greatly, but the injured worker can appeal the decision. Taking the correct approach in the appeal improves one’s chances of getting the claim approved.
When your claim is denied…
First, contact the insurer. Your claim may have been denied because there was a mistake or an omission in the filing. You may be able to correct the mistake over the phone or by submitting the missing information and your claim will be reconsidered.
If the reason for the denial is more complicated, then you will need to file an appeal to have your claim reconsidered. Contact your insurer for details on the procedure and to learn what additional information they may need.
Most important in the appeal process is ascertaining you have the correct documents. Rules and documents vary from state to state, so it is crucial that you determine the requirements in your state, obtain the correct documents, and understand the deadlines for filing each document. A missed deadline can mean another denial of your claim.
The best way to ensure your appeal is properly assembled and filed is to work with an attorney who is knowledgeable about Workers’ Compensation claims and appeals. Any claim or appeal requires detailed documentation of the incident and evidence of injury, including reports and medical records. A skilled attorney can help assemble and file the proper information as well as represent you at an appeal hearing.
If you are dealing with a work injury and need help with a Workers’ Comp claim or an appeal of a claim that has been denied, contact Attorney Todd Bergert, or click here for more information on how Attorney Bergert can help with your claim or appeal.