Dealing with Denied Workers Compensation Claims

When a workers compensation claim is denied, it can be a thoroughly frustrating experience. After all, the worker has not only suffered an injury that is affecting his or her ability to work, but a denied claim can make them feel as if nobody is taking their injury seriously.

How can insurance companies deny workers compensation claims when the claimant has a legitimate injury? Why do they deny them? And most importantly, what can you do when you receive a claim denial? Here, our workers compensation attorney in Wilmington NC provides the answers.

How and Why Do Insurance Companies Deny Workers Comp Claims?

There are several reasons why an insurance company may deny a workers compensation claim. The most common reason is actually a failure on the employee's part – the injury is not reported or the claim is not filed on time. Workers compensation insurance requires the injury to be reported as soon after the incident as possible, usually within one or two days. The employer must also report the injury in a timely manner as well. If either the employee or the employer fail in reporting within the required timeline, then the claim will almost always automatically be denied.

Another reason why a claim may be denied is due to the employer disputing the claim. Employers will often try and stall the process or get the claim dismissed by saying the employee's injury didn't happen at work. When this happens, it falls to the injured party to provide the evidence necessary to prove their case.

Another reason for a workers compensation claim denial may be that the injury doesn't fall under the state's claimable injuries. For instance, some states don't acknowledge stress-related conditions as being claimable for workers comp.

Regardless, your denial letter from the insurance company will detail the exact reasons for their decision. If you're uncertain about the reason or you think it was made in error, then you should see a workers compensation attorney immediately.

What Can You Do When You Receive a Denial Letter?

While a denial letter can cause you significant stress and frustration, keep in mind that it does not mean your case is over. You have the right to appeal the decision. But, make sure you read the letter carefully, as there is almost always a deadline attached for your appeal.

In some cases, the denial may just be the result of missed or incomplete paperwork. Therefore, contacting the insurance company to discuss the denial may be all you need to fix the problem and get your claim approved.

If the problem is more complex, then an attorney will be able to help you gather the evidence you need to strengthen your claim. Schedule an appointment with an attorney immediately to ensure your appeal is ready and filed on time.

The Rodzik Law Group's Workers Compensation Attorney in Wilmington NC Can Help

Appealing a workers compensation claim denial is a complex process that involves a lot of information and evidence gathering. Missing just one important piece of evidence can result in another denied claim and worse yet, you may not be able to present the evidence at subsequent appeal levels. Don't risk it, let an experienced workers compensation attorney help you build the strongest case possible for your appeal.

At The Rodzik Law Group, our workers compensation attorney in Wilmington NC is highly experienced in dealing with employer insurance companies and we can help you represent your case as thoroughly as possible. With our legal team on your side, you'll have the best chance of getting your claim approved.

Contact The Rodzik Law Group's workers compensation attorney in Wilmington NC today at 910-762-1199 to schedule a free initial consultation.