Denied Workers' Compensation: Frequently Asked Questions

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According to the Bureau of Labor Statistics, approximately 2.9 million workers were injured on the job in 2015. If you've recently been hurt at your job, chances are that beyond taking the time to heal, your biggest concern is supporting yourself and your family. This is where workers' compensation comes in, but even if you are legitimately injured on the job, there is a chance your claim will still be denied. If you've filed a claim and it was denied, here are a few questions you might have about what to do next:

Why Was My Claim Denied?

Depending on the state in which you live, in order to successfully be awarded workers' compensation benefits, you must meet certain criteria, and your employer must also offer benefits. Additionally, in a handful of states, your federal government will be in charge of handling your case.  

Your benefits can be denied for a number of reasons. However, here are a few of the most common:

• You Didn't Report your Injury Right Away – Depending on the state in which you live, you have a certain number of days or hours to report your injury to a supervisor or another company representative. If you fail to meet this deadline, your claim will be denied.
• You Didn't File the Claim in a Timely Fashion – After you report your injury, you must then file a claim in a timely fashion. If you miss the deadline provided by your state or the federal government, your claim will be denied.
• You Injured Yourself Away from Work – In most states, in order to be covered by workers' compensation laws while you were away from work, you must be performing a task or chore that benefitted your employer.
• Improper Medical Treatment – In many states, your employer controls which healthcare provider you visit after the injury. If you don't visit this provider, or don't seek medical treatment at all, your claim could be denied.
• Lack of Proof or Evidence – Finally, if you were legitimately injured on the job and simply didn't provide enough evidence, it could lead to a denial of benefits. To prevent this, you must make sure to gather as much evidence as possible after the accident. This includes witness testimony, pictures of your injuries and pictures of where the injury occurred.

Can I Appeal My Decision?

If you were denied, your first question will probably be: Can I appeal the decision? In most cases, the answer is "yes," but you will need to hire an attorney to help you down the path to receiving your rightful benefits. You'll want to do some additional reading to help you decide on one. Once you have an attorney, your next step should be determining why you were denied benefits. In many cases, your attorney will meet with your employer and insurance provider and discover the reason you were denied was a simple error, such as an unsigned or missing document.

However, in other cases, you and your attorney will need to take further action to ensure you get your benefits. For example, if you didn't report your injury or file a claim in a timely fashion, your attorney may be able to prove that an injury occurred on the job on a certain date based upon other evidence, such as the testimony of anyone who witnessed the accident.

Whether you were denied because you reported the injury past the deadline or didn't visit the employer-approved physician, it is still important to gather up as much evidence possible to prove you have a case. This includes reports from your physician detailing your injuries and a time sheet or other proof that you were at work when the accident occurred.

Getting injured on the job can be a scary and overwhelming process – especially if you are denied workers' compensation benefits. If you applied for and were denied workers' comp, don't hesitate to contact an attorney to discuss your options.

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9 December 2016