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What to do if your workers’ comp claim was denied

On Behalf of | Mar 5, 2018 | Workers' Compensation |

The decision came in. It was not what you had hoped for. After being unable to return to work for quite some time, your company’s insurer decided your injuries were not severe enough to warrant workers’ compensation. You went to see their doctor in good faith, but that doctor has apparently determined that your injuries were not caused by your workplace accident.

You know better, however. If your workers’ compensation claim was denied, here are three things you should do.

Do not give up hope

Having your workers’ comp claim denied is actually fairly common. Insurance companies are in the business of protecting their bottom lines. Paying out claims means fewer profits for them. So, even legitimate claims can be rejected initially in efforts to discourage you from taking further action. You have the right to find out why your claim was denied and to further prove why you deserve these necessary and legally mandated benefits.

Keep all of your records secure

Medical reports, bills, sworn statements of your abilities, and your initial claim documents are all important evidence in your case. Make a habit of keeping anything related to your work injury together, perhaps in a file or folder, and store this information in a secure place. Consider backing up copies of this information “to the cloud” online, just in case. These documents will be necessary in building your case for renegotiation with the insurer or in case the matter proceeds to court.

Lawyer up

If you haven’t already done so, consider hiring an attorney who handles workers’ compensation claims. Insurers pay attention when claimants are backed by sound legal guidance. Your lawyer can examine all aspects of the claim, bolster it where needed with further tests or evidence, and represent your interests in seeking a fair settlement. If the insurer persists in denying the claim, your lawyer can then take the matter before the court.

Remember, workers’ compensation is legally mandated by the state to cover anyone injured on the job or who sustains a serious illness because of workplace conditions. It all becomes a matter of proving that cause, something a good workers’ compensation attorney can help you do. Don’t give up hope. Your case may have hit a roadblock, but it is not the end of the road.


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