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Workers’ comp claim denied? You can appeal it

On Behalf of | Mar 2, 2018 | Blog |

You don’t normally think of your office job in Malden as particularly dangerous, but even in a seemingly safe setting, you can suffer a work-related injury. For instance, you could develop a repetitive motion injury like carpal tunnel syndrome from hours of typing or some other motion that you do continuously with your hands. When you get hurt at work, you might be able to qualify for workers’ compensation benefits. But, what if the insurer or your employer denies your claim?

Workers’ compensation insurance providers deny claims for various reasons. In some cases, it could be as simple as a clerical error and in others it could be because your employer insists that your injuries are not work-related. No matter the reason, it is important to understand why insurers deny workers’ compensation claims and what you should do to appeal the denial.

Reasons for a denial

Some of the most common reasons that insurers deny a workers’ compensation claim include the worker not reporting the injury in time, not filing a claim in time or a lack of evidence that the injury was, in fact, work-related. Sometimes, the insurer will deny a claim if the employer provides a disqualifying reason, it is impossible to determine compensation, such as for a stress-related condition, or the injured person did not receive medical treatment.

Appealing a denial

If the insurer denies your workers’ compensation claim, you can appeal it. The insurer will send you a denial letter that gives you a date by which you can file the appeal. Before you become embroiled in the appeals process, talk to your employer and the insurer about the reason for the denial and verify that it was not the result of a simple administrative error.

If there is not an easy fix to the problem, then you may need to go through the full appeals process. You will more than likely have to attend a hearing in front of judge that oversees workers’ compensation cases for the labor department or the state board. You will probably also have to provide medical documentation of your injuries and the treatments you received as well as proof that the injury was job-related.

Handling a workers’ compensation denial can be a very complicated process, however this does not mean you should give up on fighting for the compensation you deserve. If you have received a workers’ compensation denial, keep in mind that you still have options. By following the appeals process, you might be able to prove your claim and win compensation for your medical expenses and lost wages.