Steps to Appeal a Denied Workers’ Compensation Claim

About the author

Robert Golan

Unfortunately, legitimate Workers’ Compensation claims are often denied by an insurer, which leads the injured employee to hire a lawyer. Here are some of the main reasons why legitimate Workers’ Compensation claims may be denied:

  • Lack of witness to incident
  • Delayed report of injury
  • The accident report and initial medical records conflict
  • You did not pass a drug test
  • Your claim was filed after employment termination
  • Refusal to provide a recorded statement
  • Refusal to sign medical authorizations

Employers strive to deny Workers’ Compensation claims to avoid an increase in their insurance expenses and liability, and insurance companies look for some basis to deny the claim.

However, this does not have to be the end of claim process. If you accept a denial letter with no further action, it may result in the loss of your right to pursue the claim. You do, however, have the right to challenge the denial of the claim.

Appealing a Claim Denial

First, read the denial letter carefully to find notes on how to appeal the claim. Also, consider contacting the employer or the insurance company to talk about the claim denial, as it may have been a result of mistaken paperwork.
If your claim is still refused, you have the option to appeal the claim denial.

While the appeals process varies by state, the first level is often at an administrative hearing in front of an administrative law judge. At this hearing, you will present evidence to support your claim. It is important to be conscious of the time limits of the appeal and the thoroughness of your evidence supporting the claim.

Talk to an Attorney

Do not accept the initial denial of a Workers’ Compensation claim. Contact a Long Island work injury compensation lawyer as soon as you can to ensure you get the justice you deserve.

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