Why Was My Workers Comp Claim Denied?

Last Updat­ed on April 18, 2023 

Ques­tion 1: What is work­ers’ com­pen­sa­tion?

Answer: Work­ers’ com­pen­sa­tion is a type of insur­ance that pro­vides finan­cial com­pen­sa­tion to employ­ees who have been injured or become ill while per­form­ing their job duties. It is designed to cov­er med­ical expens­es, lost wages, and oth­er costs asso­ci­at­ed with the injury or ill­ness.

Ques­tion 2: What are some of the rea­sons why an insur­ance com­pa­ny might deny a work­ers’ com­pen­sa­tion claim?

Answer: Insur­ance com­pa­nies may deny a work­ers’ com­pen­sa­tion claim if they believe that the injury or ill­ness was not caused by the employ­ee’s job duties, if the employ­ee did not fol­low the prop­er pro­ce­dures for fil­ing a claim, or if the employ­ee has a pre-exist­ing con­di­tion that was not dis­closed.

Ques­tion 3: What should I do if my work­ers’ com­pen­sa­tion claim is denied?

Answer: If your work­ers’ com­pen­sa­tion claim is denied, you should con­tact your state’s work­ers’ com­pen­sa­tion board to appeal the deci­sion. You may also need to con­tact an attor­ney to help you with the appeal process.

Ques­tion 4: What infor­ma­tion do I need to pro­vide to appeal a denied work­ers’ com­pen­sa­tion claim?

Answer: To appeal a denied work­ers’ com­pen­sa­tion claim, you will need to pro­vide med­ical records, wit­ness state­ments, and oth­er evi­dence that sup­ports your claim. You may also need to pro­vide a detailed expla­na­tion of the injury or ill­ness and how it was caused by your job duties.

Ques­tion 5: What hap­pens if my appeal is denied?

Answer: If your appeal is denied, you may have the option to file a law­suit against the insur­ance com­pa­ny. You should con­tact an attor­ney to dis­cuss your legal options.

Ques­tion 6: How long do I have to file a work­ers’ com­pen­sa­tion claim?

Answer: The time lim­it for fil­ing a work­ers’ com­pen­sa­tion claim varies by state. Gen­er­al­ly, you should file your claim as soon as pos­si­ble after the injury or ill­ness occurs.

Ques­tion 7: What hap­pens if I don’t file my claim with­in the time lim­it?

Answer: If you do not file your claim with­in the time lim­it, you may not be eli­gi­ble for work­ers’ com­pen­sa­tion ben­e­fits. You should con­tact your state’s work­ers’ com­pen­sa­tion board to find out the spe­cif­ic time lim­it for fil­ing a claim in your state.

Ques­tion 8: What hap­pens if I am not able to work due to my injury or ill­ness?

Answer: If you are not able to work due to your injury or ill­ness, you may be eli­gi­ble for tem­po­rary dis­abil­i­ty ben­e­fits. These ben­e­fits pro­vide finan­cial assis­tance while you are unable to work.

Ques­tion 9: What if I dis­agree with the deci­sion of the work­ers’ com­pen­sa­tion board?

Answer: If you dis­agree with the deci­sion of the work­ers’ com­pen­sa­tion board, you may have the option to file an appeal. You should con­tact an attor­ney to dis­cuss your legal options.

Ques­tion 10: What if I am not sat­is­fied with the out­come of my appeal?

Answer: If you are not sat­is­fied with the out­come of your appeal, you may have the option to file a law­suit against the insur­ance com­pa­ny. You should con­tact an attor­ney to dis­cuss your legal options