PLEASE NOTE: Until further notice, our offices will remain open during normal business hours. To ensure the safety of our clients, we are recommending contacting us by phone as your first option, though we are available to meet in person if necessary, and are taking all proper precautions in such cases. As always, initial phone consultations are always free.

What is next after a denied workers’ compensation claim?

| Jan 2, 2020 | Uncategorized

If you received an injury from an accident in the workplace, you understand how difficult it can be to pick up the pieces and move forward. How can you afford medical bills you weren’t expecting? What will happen to your income if you miss too much work? These are only a few of the questions you may have about what to do next.

Thankfully, there is financial support available to individuals who experience an injury on the job. Through your North Carolina employer’s workers’ compensation coverage, you can secure benefits that will allow you to address your medical expenses and recover some of your lost wages. You file for these benefits expecting to get the help you need soon, only to experience devastation when your claim comes back denied.

Understanding why 

When you’re hurt and you can’t get back to work just yet, a denied workers’ comp claim is devastating. It’s a setback, but that doesn’t necessarily mean that you won’t be able to get what you need at some point in the future. Through an appeal, you can challenge the insurance company’s reason for denying your claim and address any concerns the case reviewer had.

These insurance companies are primarily concerned with their own bottom above your best interests. Even with a valid work injury and obvious financial need, you still may not be able to get what you need right away. Some of the most common reasons for a denied claim include the following: 

  • The insurance company thinks that your injury is not really compensable or likely did not require any medical treatment.
  • Your employer is disputing the claim by challenging your account of what happened or the nature of your injuries.
  • You did not include enough evidence that your injury relates to your job in any way.
  • You did not report the injury to your employer in enough time, or you did not file your claim within the appropriate window.

When you appeal, you can include additional documentation, such as medical records, that further prove your claim and validate your need for workers’ compensation benefits. You will have to file your appeal within a certain number of days after learning of the denial.

An experienced workers’ compensation attorney is the help you need to successfully navigate the workers’ compensation claims and appeals process. Whether you need to complete your initial application or you want to know what’s next after an unsuccessful attempt, you do not have to take one step alone.

FindLaw Network