Most businesses offer workers’ compensation to cover costs for employees who are injured or become ill while on the job. While the U.S. Bureau of Labor Statistics reported that approximately 2.8 million nonfatal workplace injuries and illnesses were claimed in 2017, not all of these claims were approved. Here’s what to do if your claim is denied.
Why Might Workers’ Compensation Be Denied?
Employers will often dispute a workman’s comp claim if they do not believe the injury or illness occurred as a result of work-related activity. There are also time limits and paperwork guidelines — failure to report the injury or file a claim by a specific deadline can result in a denial of benefits. Other common reasons for denials include preexisting medical conditions, being under the influence at the time of the injury, filing a claim after being fired or laid off, and filing for a minor or non-covered illness or injury.
What Should You Do If Your Claim Is Denied?
If your workman’s comp claim is denied, you’ll be informed in writing with an explanation. Review the document carefully and make sure the denial is not the result of a simple mistake, such as a clerical error that could easily be cleared up.
If you believe the reasoning is unjust, contact a workers’ comp attorney. They’ll help you determine if you have a case and help you navigate the appeals process, which varies by state. Do so right away, as you’ll be given a deadline by which you must file your appeal. Failure to meet the deadline can put an end to the appeals process entirely.
What Happens When You File an Appeal?
Upon filing an appeal, you’ll typically be granted a hearing in which you’ll be required to present evidence, such as medical records or affidavits from eyewitnesses, proving the validity of your workers’ compensation claim. Your employer may also have a lawyer present to defend their reason for denying your claim. It will then be up to a judge to decide whether you are entitled to receive workers’ compensation.
If you’re denied workers’ compensation, the team at Vincent J. Criscuolo & Associates can help. These skilled attorneys will help you fight to collect the compensation you deserve. Based in Rochester, NY, the firm also specializes in social security disability claims and personal injury cases. Visit their website to learn more and call (585) 232-3240 to schedule a consultation today.