Workers’ Compensation Claim Denial Reasons

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Categories: Other NewsPublished On: August 8th, 2017

If you have been injured or suffered an illness due to your work or work environment,  it is likely that you have filed a workers’ compensation claim. However, workers’ compensation claims may be denied for a number of reasons and it is important that you know what to do thereafter. This article will discuss reasons why workers’ compensation claims are denied and provide advice on what to do afterward.

One of the most common reasons a workers’ compensation claim is denied is that the claim is not filed or reported on time. It is a legal requirement that a worker report the claim immediately or within a matter of days to the employer. Thereafter, the employer must inform their workers’ compensation insurance carrier as quickly as the employer received the report of the injury.

Another common reason why workers’ compensation claims may be denied is that the employer has disputed the claim. Your employer may dispute that the accident happened at work or that your current injury or illness is as a result of the accident, exposure or overuse. If this happens to your claim, you will need to gather additional evidence to support your workers’ compensation claim. This can be done by having eyewitness accounts that the accident did indeed occur at work or by providing a statement from your doctor stating that your condition is in fact the result of your workplace environment.

It must be noted that the employer or its insurance company is likely to look for any possible reason to deny a workers’ compensation claim. In fact, it has been reported that insurance companies routinely deny workers’ compensation claims in hopes that the employee give up on their claim. With respect to the employer, the denial of a claim means lower insurance expense and liability.

In order to determine the reason why your claim was denied, you must look at your claim denial letter. The claim denial letter will outline the reasons for the denial as well as steps for appealing the denial and deadlines associated with appealing the denial. Accordingly, it is important that you read the letter carefully and take note of any appeal deadlines.

If the denial was simply a matter of mistaken paperwork or other such administrative errors, your first step is to contact your employer of employer’s workers’ compensation insurance carrier to see if the mistake can be cleared up and your claim allowed. However, if your employer still refuses to allow your claim, you may want to appeal the claim denial. It is important to note that the process of appealing a workers’ compensation claim denial involves complex legal processes and requirements. Therefore, it is important that you speak to a workers’ compensation lawyer as soon as possible. A workers’ compensation lawyer can help you determine whether an appeal of your workers’ compensation denial is worth the time and effort or not and assist you with legal representation.

For an attorney in Anchorage Alaska who can help with your workers’ compensation claim, seek out a law firm with experience handling workers’ compensation claims.

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