Workers’ compensation is a breath of fresh air for someone who is injured on the job; until it’s not. What if your claim gets denied? Are there common reasons denials happen? What should you do about it if you find yourself in that situation? The following breaks it down.
Reasons Claims Are Denied
While there are a dozen reasons a claim could get denied, there are some that are more common than others. These include:
- Filing Too Late – There are deadlines associated with almost every step of receiving workers’ compensation. First, you have to report your injury to your employer almost immediately. Next, you have to file a claim with the state within the statute of limitations. Every state has a different statute, so it’s important you understand yours.
- Leaving Your Job – Whether you were fired, quit or got laid off, leaving your job before filing a workers’ compensation claim could be cause to have it denied. You could have a perfectly good reason for the delay, but that will have to be proven in court.
- Not Meeting Guidelines – In order for you to receive workers’ compensation benefits, your injury or illness has to meet certain guidelines. First, it has to be directly related to your job. Second, your state may have restrictions regarding cumulative trauma or long-term emotional work stress. Finally, your injury must be severe enough to qualify.
What You Can Do
If your claim was denied, all hope is not lost. You may have a perfectly good explanation as to why you filed late, left your job before filing or didn’t meet the guidelines. Read your denial letter closely to fully understand the reasoning behind it. It’s possible there was a clerical or paperwork error that simply needs to be corrected.
If you feel the denial is unjust, contact an attorney to see what you need to do to get an appeal started. You’ll need medical and other evidence to show why the denial was unjust. Your lawyer can help you gather that evidence. Each state has varying levels of the appeals process, and your attorney can help you determine where to turn next.
Contacting Your Lawyer Today
Whether you’ve already decided to appeal a denial or are wondering whether you should, contact a workers’ comp lawyer in Queens, NY for assistance. With the right legal professional by your side, you’ll be better equipped to navigate a world you may not be too familiar with. Call your lawyer today to get started.
Thanks to Polsky, Shouldice & Rosen, P.C. for their insight into workers compensation and denied claims.