When one suffers an injury or illness, they are likely to take steps to better the situation. This often means seeking medical attention to help treat the matter. However, when a worker is injured on-the-job or is diagnosed with a workplace illness, there is more that the worker can do. Seeking workers' compensation benefits could be very valuable, as these benefits could help offset medical bills and lost wages. However, going through the application process does not always guarantee that the worker will be approved for benefits.
What can one do after workers' comp denial? Generally, when workplace injuries and illnesses occur, they are covered by one's employer's workers' compensation insurance. Thus, it seems obvious that when a claim is filed after such an event, coverage will be approved. Unfortunately, sometimes these claims get denied, making it important to understand what the next step is after a denial.
There are several reasons why a claim will be denied. This could include factors such as the injury not being timely reported, the claim was not filed in time, the employer is disputing the claim, the injury listed is not compensable, there is no medical treatment available or there is insufficient evidence proving that the injury or illness was work-related.
Depending on the reason for denial, it might be lucrative for an employee to file for an appeal. In most cases, an appeal must be filed within 30 days of receiving a denial. However, before issuing an appeal, it is important to understand your matter, as it might be resolved without taking the appeals route. It could simply be a clerical error or a simple misunderstanding. But if an appeal is the route your are taking, it is important to collect further documentation, which includes medical records that could help prove you are eligible for these benefits.
Suffering a work injury or illness is likely unexpected. It is also a matter that could render an employee unable to work for a certain period of time. Thus, seeking workers' comp benefits might be the only way a worker can make ends meet while they recover from the injury or illness.
Source: FindLaw, "Workers' Comp Denied? Here Are Your Next Steps," accessed Feb. 24, 2018