There are many complaints that you may hear about the workers’ compensation benefit process. Perhaps it is taking them too long to process your claim, or you feel as if the settlement amount isn’t fair. One of the most common complaints, however, is to heart hat your claim was denied. Insurance companies may find themselves under pressure to keep premium costs low and scrutinize claims as harshly as possible. You see, the more claims that are paid, the higher the premiums they must charge employers.
What Happens When Workers’ Comp is Denied
If you find that your workers’ compensation claim is denied, you still have options. There are many reasons why a claim may be denied, and this it the first determination you must make. In many cases, an employee did not meet the eligibility requirements, and there are various reasons given for this. Here are some of the most common reasons:
- You must report your injury on time, according to the state you reside in. Because of this, if your injury was not reported on time, you may be denied. In most cases, you must report within a couple of days.
- You must also remember to file your claim within 30 to 90 days depending on the state.
- Your employer may choose to dispute your claim because it happened outside of work, horseplay occurred, or another disqualifying reason.
- In some cases, an injury may not be compensable or difficult to prove.
- If you have not received any medical treatment, you are lacking proof and could be denied.
- Perhaps your injury is questionable in regards to it being work-related. If there is indiscretion about this, they may deny your claim.
Of course, you have the option to appeal your claim denial, but you should always speak to an attorney before moving on. There are deadlines to make your appeal, making it a complicated legal process from start to finish. You must have sufficient evidence such as medical records and more. Call us today at Maggiano, DiGirolamo & Lizzi for more.