I still remember my accident like it was yesterday. One minute I was driving my daughter to school and the next I was waking up in a hospital bed. It was frustrating to deal with the emotional trauma of forgetting an entire week of my life, in addition to stressing about my small child. Fortunately, we were both able to recover, but it wasn't easy walking dealing with the medical bills that accompanied the accident. I found myself struggling with things as simple as answering the phone, because I was nervous about dealing with another insurance adjuster. Fortunately, by working with a lawyer, I was able to make sense of my situation. I know that you can overcome difficult challenges too, which is why I shared my story on this website.
Despite the fact that you were injured on the job, it is possible that your workers' compensation claim could be denied. When this occurs, it is important you understand why and what you can do to file an appeal.
Why Was Your Claim Denied?
There are several reasons why claims are usually denied. For instance, the insurance company could deny your claim if you did not immediately notify your supervisor that you were injured.
A denial is also possible if the insurance company does not believe that your injury was work-related. The company could argue that your injury was old or that it actually occurred in another location.
Denial is possible if the insurance company feels that you were partially at-fault for injuries. Although workers' compensation is supposed to be available to employees injured in the workplace despite the circumstances, this is not always the case. For instance, if the insurance company claims that you were intoxicated when the accident occurred, you could be denied.
When your claim is denied, the exact reason why should be stated in the denial letter. If it is not, your workers' compensation attorney can contact the company to determine why.
How Can You Appeal?
The appeals process can vary from state to state, but there are some basic steps you can take. The denial letter you received should state what steps you need to take to appeal. Some states require you to complete a form and submit it to the insurance company to appeal. You might have to submit your request for an appeal to your state's labor board.
It is very important that you understand which action you need to take. There are time limitations on how long you have to appeal. If you do not file your request for an appeal before that time is reached, you could lose your chance to receive benefits.
You and your attorney are tasked with proving why the insurance company was wrong for denying your claim. Evidence is key in helping your case.
For instance, if the insurance company denied your benefits because it believed your injuries occurred in another location, you can provide witness statements from co-workers attesting to what happened. You can also request any security footage that the company has that might have captured the moment you were injured.
The best way to respond to a denial of workers' compensation benefits is to work with an experienced attorney to craft an appeal. Contact an attorney, such as those at Franco Law Firm, as soon as possible to avoid any delays in the appeals process.