When Workers' Comp Benefits Are Denied: Don't Give Up The Fight

Hurt workers are entitled to be paid several valuable benefits after a work-related injury or when suffering from an occupational illness. Unfortunately, sometimes workers' comp carriers deny hurt workers the coverage they need and deserve. If you've been denied, don't give up. Take a look at the following tips to get your claim reinstated and back on track.

Why Was the Claim Denied?

Take a close look at the letter from your carrier to find out why the claim was denied. In some cases, the reason has to do with minor discrepancies in the claim form and other information. Claim forms must be accurate as far as dates, times, and witnesses are concerned. Try phoning the workers' comp carrier if you think the denial is based on a simple error in the claim form or other easily rectifiable issues. Here are some other common reasons for the denial:

  1. Drugs: When you appear at the hospital for a work-related injury, you will be tested for the presence of drugs or alcohol. If you are found to be under the influence, your claim could be denied. If you have a prescription for the substance, however, the denial is based on an unfair ruling.
  2. Statements: Some states allow the insurance carrier to follow up on claims by phone, and those interviews are usually recorded. You may disagree with being recorded, and your refusal should not be a reason for a denial of benefits. Recorded interviews without the support of an attorney are not recommended since the insurance adjuster can trick workers into saying something that damages their chances for a claim.
  3. Witnesses: Coworkers or others who saw the accident happen or know about your ongoing occupational illness are valuable assets in a quest to get benefits. Unfortunately, the lack of corroboration can also sink your claim. You may be able to find witnesses to support your claim as long as you don't wait too long to amend it.

When You Cannot Resolve the Issue

When you see insurance companies advertising on television, it always seems that they are there for the protection and benefit of you, the victim. That is far from reality, however. Insurance companies make a profit using premiums, and when they must pay for a victim's claim, they lose money. They have little to no incentive to cooperate with hurt workers, and they know many will drop the claim if they remain steadfast in their denial of benefits. That is why you may need to talk to a workers' compensation lawyer when your attempts to resolve issues are unsuccessful. Talk to a workers' compensation attorney about your accident, your attempts to file a claim, your denials, and your medical treatment today and get the help you need to get your benefits.