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What to do when your workers' compensation claim is denied

Sustaining an injury at or acquiring a disease from work is a traumatic experience that can lead to years of physical and emotional pain. The beginning of recovery comes with filing a workers' compensation claim so you can receive financial support during this difficult time.

Unfortunately, the process is not as simple as filling out some paperwork and waiting for the money to arrive. Its complexity makes the chances of a denial likely. Do not let that make you give up. With professional help, you can take action again to successfully secure workers' compensation benefits.

Reasons for denial

Understanding the reasons for a denial can help you prevent it from happening again. You can also find out from your employer or the insurer the specific reason for your denial. Common causes include the following:

  • Filling out documents incorrectly
  • Failing to submit all or enough evidence
  • Turning in the application past the statute of limitations

Your employer may also dispute your claim and try to prove your version of the events is false.

What to do next

If your application was late, your case is likely over unless you have an occupational disease that took several years to show up, such as asbestosis. If you made an error or need to provide further evidence, you can file a form to request a hearing with the Industrial Commission. There, you can further present your case.

If your employer or the insurer disputes the claim or certain bills, you will have to go through mediation. You both agree on a neutral mediator to help you reach an agreement. If this process fails to result in a compromise, you will have to go to trial.

If things still do not turn out well for you, you can make an appeal. The bottom line is that you do not need to fear a denial; it does not mean the end of your journey.

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