Workplace injuries can disrupt your life, causing physical and financial hardships. When you file a workers' compensation claim, you hope it will provide the support you need during this difficult time. However, sometimes claims get denied, which can be frustrating and confusing. In this helpful guide from our workers’ compensation attorneys, we will outline some common reasons for claim denials and offer helpful tips on what to do if your claim gets denied.

Common Reasons for Workers' Compensation Claim Denials.

Failure to Report the Injury in a Timely Manner.

One of the most common reasons for claim denials is a delay in reporting the injury to your employer. It is crucial to notify your employer as soon as possible after the incident occurs.

Lack of Medical Evidence.

Insufficient medical evidence to support your claim is another frequent reason for denial. Medical records, expert opinions, and thorough documentation of the injury are essential in proving the claim's validity.

Pre-existing Conditions.

If the insurance company believes your injury is unrelated to work and stems from a pre-existing condition, they may deny your claim. However, you are still entitled to compensation if the work environment aggravated or exacerbated your condition.

Disputes Regarding the Nature or Cause of the Injury.

Conflicts may arise when the insurance company questions whether the injury occurred on the job or was caused by work-related factors. In such cases, it is crucial to gather witness statements or any available evidence that supports your version of events.

Steps to Take If Your Claim Gets Denied.

Carefully Review the Denial Notice.

When you receive a denial notice, make sure to read it thoroughly to understand the specific reasons for the denial. This information will be vital when preparing your appeal.

Collect and Organize All Relevant Documentation.

Gather all medical records, accident reports, witness statements, and any other evidence supporting your claim. Organize them meticulously, ensuring you have all necessary materials to build a strong case.

Consult with a Workers' Compensation Attorney.

Seeking legal counsel is crucial when facing a denied claim. A knowledgeable workers' compensation attorney will provide guidance, assess the strength of your case, and help you navigate the appeals process.

File an Appeal Within the Deadline.

Each state has specific deadlines for filing workers' compensation appeals. Ensure you are aware of the timeframe and submit your appeal within the stipulated period. Missing the deadline could jeopardize your chances of receiving benefits.

Work with Your Lawyer to Strengthen Your Case.

Your lawyer will help you build a compelling case by advising you on the necessary legal procedures, collecting additional evidence if needed, and representing your interests during hearings.

Prepare for Mediation or Hearings.

In some cases, mediation sessions or formal hearings may be necessary to resolve the dispute. Prepare yourself by reviewing your case with your lawyer, practicing your testimony, and understanding the legal process involved.

Seek Alternative Options.

If your appeal is unsuccessful, explore alternative dispute resolution methods, such as a settlement negotiation or mediation. Your lawyer will guide you through these options and help you make an informed decision.

Has Your Workers’ Compensation Claim Been Denied?

Don’t give up on it yet! Contact the team of workers’ compensation attorneys at Mishra X Trial Lawyers. We represent workers against employers in labor and employment litigation, including asserting workers’ compensation and workplace retaliation claims. Our depth of experience and reputation enables us to maximize recovery for our clients, even in challenging claims. So even if your claim was initially denied, that doesn’t mean you won’t get the money you’re owed.

You can learn more about our practice areas online, or contact us to schedule a free consultation today.