Your Options After a Workers’ Compensation Claim Denial

If your workers’ compensation claim was denied, you may be worried about what your options are moving forward. A claim may be denied for several reasons, so it’s important to review a denied form and see if the issue can be resolved with the claims adjuster. In other instances, you may need to submit an appeal of the denial. 

Appeal Filing Timeline

If your lawyer determines that filing an appeal could yield an approval result, he or she can help you complete the adjudication application. A hearing will then be scheduled. To get ready for the hearing, you will have to showcase evidence that supports your claim. There may be a certain number of days after the denial notice for you to send in an appeal, so it’s imperative that you respond quickly.

Reasons for Denial Claim

Receiving a workers’ compensation claim denial can be scary, as you worry about how you’ll overcome the financial obstacles that the workplace accident caused. Unfortunately, those handling your claim are likely to view it in a way where they want to safeguard the company’s profits, so having a lawyer can protect you from wrongful denial or retaliation. Examples of reasons for a claim denial are: 

  • Missed deadline
  • Claim was filed after leaving job
  • There was a dispute about the nature of injury
  • Information was incorrect or not provided
  • Employer mishandled the employee’s claim

When a workers’ compensation claim is submitted, insurance companies are usually fast to find reasons to minimize or deny it. As a workers compensation attorney, like one from Rispoli & Borneo, P.C. would attest to, understanding your options in responding to a claim denial can help you seek the outcome you need to recover. 

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