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What To Do if Your Employer Denies Your Workers’ Comp Claim

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Workers with hurt foot. What if employer denies workers' comp claim

As a good part of your life is spent at work, you would want to ensure that the people responsible for your health and well-being take that responsibility seriously. If you sustain an injury at work, it is fair that your employer compensates you adequately.

Unfortunately, some do not. What do you do in these cases? Find out why employers deny workers compensation claims and explore what you can do if your organization refuses yours.

Can an Employer Deny Your Comp Benefits?

Yes. Your employer can deny workers compensation claims. If your worker’s compensation claim is legitimate, they should not deny it, but this happens often. It is also no news that people have tried to take advantage of the workers’ compensation policy to claim benefits they are not due. Below, we outline reasons for employers denying workers’ comp claims.

When Do Employers Deny Workers’ Comp Claims?

Your employer will reject your workers’ compensation request in one of the following instances:

  • When the Claims Do Not Meet Deadlines

There are strict rules regarding filing your workers’ comp claim; one of these is timing. We advise that you file your worker’s comp request immediately after the incident if you can. If you cannot because you have to get immediate medical help, then you should file your worker’s comp claim with your employer as soon as you leave the hospital. You typically have two years to file your claim. If you fail to do so, you might be forfeiting all benefits.

  • When There Are No Witnesses

It is hard to prove a case when there are no witnesses because this could mean that you are falsifying the situations surrounding your injury. Employers could reject your claim if you did not have any witnesses present when you got injured.

  • When the Injury Is Not Work-Related

Many workers try to pass off non-work-related injuries as work-related so they can get some relief on medical bills. Of course, this makes employers quite wary of workers’ comp claims. If they find out that your stated injury is not work-related, they will reject your requests.

  • When You Were the Aggressor

If you were the aggressor in an altercation that led to injury and you file for workers comp claims, your employer will very likely deny your request.

What Are the Next Steps?

If your employer denies you workers’ compensation for no good reasons, that is not the end of the road. You certainly can still ensure that they get the benefits that you deserve with these two steps:

  • Find Out Why

In some cases, you might think that your employer has denied your workers’ comp claim when they have not. Employers or their insurance companies delay workers’ comp benefits in some rare cases because of a filing issue or a misunderstanding. It is vital to inquire from your employer about your claim’s status to ensure that nothing you could sort out is holding it back.

  • Appeal the Claim

If your employer denies your worker’s comp claim, you can appeal through a professional Workers’ Compensation Attorney.

Your employees’ insurance providers would typically provide you with a denial letter. This should state a deadline for filing an appeal. During this period, you will have the liberty to make multiple appeals.

How Do You Appeal Your Claim?

To apply for a hearing, you need to contact the Workers’ Compensation Commission (WCC). At your hearing, the WCC commissioner will hear your case and approve or deny your benefits based on your case’s strength. This is why it is crucial to have the best workers’ compensation lawyers walking with you through the process.

There are multiple layers of appeal in this system. This means that you can appeal the commissioner’s decision if it does not turn out in your favor. However, you would need to file a request within 14 days of receiving the commissioner’s verdict. Sometimes, you might need to pay a filing fee before you can appeal.

Your lawyer will advise you whether this is applicable in your situation. You could appeal through state courts if the WCC denied your workers’ comp claim. It means that your lawyer needs to file a lawsuit within 30 days of receiving the commission’s decision.

Get an Experienced Workers’ Compensation Lawyer to Represent You Today!

Many believe that filing a workers’ compensation claim and getting benefits from an organization is an easy process. It is not. To ensure that you get the benefits you deserve, you would need a great workers compensation lawyer. At Mike Bell Injury Law, we will help you handle any eventualities from applying to your organization’s insurance company for workers’ comp benefits to appeal if they deny it. Contact us to get started.

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