When dealing with a workplace injury, the medical expenses and financial issues due to losing work are often overwhelming enough without being denied your workers' comp claim. You should know, however, that many of the common reasons for a denial can be remedied, which can put you back on track for your eligibility. Read on to learn more about common denial issues and how to get your claim reinstated.
You will be informed in writing of your workers' comp claim denial, either from your state's workers' comp board or your employer's workers' comp insurance company. Some common rejection issues are as follows:
1. The accident was too minor to require medical attention. If your injury could have been remedied with the contents of most first aid kits, your claim may be denied. Minor cuts, bruises, blisters, etc. should be treated immediately with a first aid kit, but be sure to follow up with professional medical care if infection sets in or further unforeseen complications arise.
2. The accident did not occur at work or was unrelated to your job. You are generally covered for accidents while at work or at a work-sponsored event, such as a company softball game at the park or an off-site holiday party. You are not covered for your commute, however, unless you are driving a company-provided vehicle.
3. You waited too long to file your claim. You must abide by your particular state's requirements for reporting the accident to your supervisor and for filing a workers' comp claim. There are exceptions to this rule, however. If your injury resulted in an extended hospital stay or you were incapacitated from your injury, you may be granted an extension. Additionally, for injuries that did not become apparent until some time later, you can extend the filing deadline to the point at which your condition was diagnosed by a doctor. For example, carpal tunnel syndrome is a repetitive motion injury that may take months or even years to become debilitating. Once you are diagnosed, you must file a workers' comp claim as soon as possible.
Oftentimes, your denial letter cites errors or omissions that can be remedied with a quick phone call to the claims representative. Typographical errors, missing information or other misunderstandings can often be cleared up with a claim amendment or attachment, depending on the rules in your state.
Your denial letter will also likely contain important information about how to file an appeal. Be sure to pay close attention to the deadlines for filing: often you only have a few weeks to appeal your denial. The appeals process varies but may involve appearing before a board to argue your claim. The appeal board is not the final step; in most states there are several higher appeal hearing levels.
Being denied workers' comp insurance and dealing with appeals can be extremely stressful, so contact a workers' comp attorney, such as those at Hamilton Law Firm, P.C., as soon as possible to get some support and to help you get the benefits that you need and deserve.