You can appeal a denied workers’ compensation claim

On Behalf of | Jun 4, 2018 | Claims Process, Workers' Compensation

Workers’ compensation is an invaluable tool that many of us need at some point in our careers. This is doubly true if you work a hazardous vocation like construction. No matter how careful you are, lurking dangers like slipping on a ladder or being struck by heavy materials are always nearby.

Being injured on the job is a pain; literally, and because of the paperwork. If you’ve reported your accident, filed your claim, waited on bureaucracy and then had your claim denied, it can be downright infuriating. You do have options, though. If you think that your employer is legitimately in the wrong about denying your compensation claim, you may have the opportunity to appeal their decision.

Know why you were shut out

The first step in appealing a workers’ comp denial is knowing specifically why the powers that be decided you didn’t deserve a payout. Review your denial letter and provide a copy of it to your attorney should you decide to pursue an appeal; your employer’s reasoning should be clearly explained there.

Reasons for denial will vary from one situation to the next. For the most part, though, your employer will probably claim one of these five reasons for denying you workers’ compensation:

  • Injury not reported to supervisor – If you failed to report your injury to your supervisor in a timely manner, your employer may have grounds to deny your claim. It might not be glamorous, but swallow your pride and tell the boss you’re hurt.
  • Claim not filed soon enough – Just like reporting an injury, if you failed to file your workers’ compensation claim in a timely manner, it will most likely be grounds for denial.
  • Employer doubts validity – You must be injured while doing your job to be eligible for workers compensation. Being injured while off the job site or because of horseplay will most likely not be legitimate grounds for compensation.
  • Did not require medical attention – Employers take workers’ compensation claims seriously, and if you were not seriously injured – or at least not enough to require medical attention – they will most likely not agree to a workers’ comp payout.
  • Not enough proof – Similar to an employer doubting the validity of your claim, you may be denied compensation if your employer is unsure whether you sustained your injures while on the job.

If you’ve been denied workers compensation for these or any other reason, speak with a personal injury attorney. They may be the resource you need to get the compensation that will get you back on your feet.

Making an appeal

If you decide to go forward with your appeal, your denial letter will most likely tell you how much time you have to do so. The appeals process is often quite complicated and the assistance of an attorney will be critical.

Workers’ compensation appeals are generally presented before an administrative law judge. Be sure to bring as much documentation as possible to help your case. This includes medical records, reports of the location of your accident, the circumstances of your accident, your denial letter, your timesheet proving you were working at the time – it is difficult to have too much proof.

Stay positive on your road to just compensation. Just because you were denied once doesn’t mean things can’t turn around and yield in your favor.