Denied Workers’ Comp? 5 First Steps to Appeal

According to the US Bureau of Labor Statistics (BLS), there were nearly 3 million workers in the United States who were injured or became ill at their workplace in 2012.

Denied Workers' Comp Claim

More than 4,500 on-the-job fatalities occurred that same year. The fact is that workplace injuries are extremely common, and workers who injure themselves while doing their job deserve a fair shot at obtaining benefits from workers’ compensation.

If you are injured on the job, one of the best ways to get fair compensation for your injury is workers’ compensation. In a “no-fault insurance program”, you receive benefits for medical treatment, disability, and lost wages from workers’ comp – no matter which party was at fault for the injury.

However, you should keep in mind that it is not always easy to get your workers’ compensation approved. The workers’ compensation insurance carrier or your employer might argue that you do not need medical treatment, you did not suffer a serious injury, you do not have to take time off work, or that your injury did not actually take place at the workplace.

First 5 Steps to Appeal a Denied Workers’ Comp Claim

If your claim for workers’ compensation is denied, you are entitled to appeal the decision. There are many reasons why your claim may be denied. Here is a brief look at the first 5 steps to appeal your denied claim:

  • Consult an Attorney: If you do not already have an attorney helping you with your workers’ compensation claim, you should get one. Appealing the denial of a workers’ comp claim can be an extremely complicated process. If your claim was denied the first time you filed, having an attorney around is a good idea as they can collect the right evidence, fill in the missing pieces, and file your paperwork correctly to make sure that you have the best chance at a successful appeal.
  • Contact an Insurer: Next, you should contact the workers’ compensation insurer to find out the reason behind the denial of the claim. In some cases, a claim is denied for something as minor as a mistake on one of the forms or a missing piece of paperwork.
  • Request a Reconsideration of the Appeal: If there is additional or new information to consider, your workers’ compensation insurer may be able to reconsider your claim. You should request the insurer to reconsider the appeal.
  • File Paperwork for Appeal: The appeals process for workers’ compensation varies widely from state to state. However, there is an application form that you can fill out to have your denial adjudicated. In some states, there may be different forms to appeal different types of claim, such as occupational disease or injury by accident. You should also keep in mind that there may be important deadlines for filing your appeal, so you need to make sure that you file your application on time.
  • Collect Evidence: Like a trial, the process of a worker’s compensation claim requires the collection of evidence to support your claim. You should gather hospital bills, medical records that show the extent of your injury/injuries and recommendations from your doctor about returning to work in a limited capacity or missing work. It is also essential to collect any evidence that you can from the accident site – this could mean getting access to work logs, security tapes, and talking to witnesses of the on-the-job accident that caused the injury.

In many cases, employers or their insurance carriers refuse to pay workers’ compensation benefits to employees who are injured or sick due to a workplace accident. If this happens to you, you should immediately contact a lawyer adept at handling workers’ compensation.

Sternberg & Associates is Here to Help!

If you or a loved suffers an on-the-job injury, you should seek the help of the dedicated attorneys at Sternberg & Associates to assist you in filing a successful claim. If your claim is denied, your legal counselor can also help you with an appeal. Contact us at 561-687-5660 for a free consultation and to get the best legal representation to protect your rights.

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