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Workers’ Compensation Claim Denied: What Should I Do Now?

Posted on 08/16/21 by admin in Workers' Compensation

Having a job comes with expectations that you may have with your employer. One expectation could be safety in the workplace. Unfortunately, accidents happen. However, it could be the employers responsibility to take care of their employees. The system that many businesses have in place in case of a workplace accident is called workers’ compensation. To qualify, the first step is to file a claim and report the injury to the employer. However, there are cases where the result of a claim comes back saying, Workers’ Compensation Claim Denied. All hope may seem lost but you may still get back compensation for your work injuries.

There are many reasons why results come back as Workers’ Compensation Claim Denied. Once a claim is denied it’s up to you to prove your side. Workers’ comp. can be denied for reasons that may be clear or unclear. 

Overview Of What Qualifies A Workers’ Compensation Claim

First, ask yourself, “was my injury due to a work-related job or when I was clocked in?” If the answers are yes then ask yourself, “did I report my injury to my employer AND file a worker’s compensation claim with the state where my employer resides?” If you answered yes to both, you may have a valid claim. However, if either answers were no then this may be why the results came back as: Workers’ Compensation Claim Denied. Nonetheless, there are more factors as to what qualifies your work injury case for compensation.

Overview Of What Qualifies A Workers’ Compensation Claim

Another factor to keep in mind is when you filed for workers’ compensation. Reporting your injury to your employer and filing for workers’ comp. are both different steps in the process. However, both are very important. To be considered for work injury compensation, the claim must be filed before the statute of limitations runs out. The timeline is different in every state/territory. For example, in Maryland there are 60 days from the date of the accident to file a claim and in Washington DC it’s 30 days from the date of the accident. Timing is everything for a successful workers’ compensation case. Moreover, there are other factors which play into work injury compensation being accepted or denied. 

Not every business is alike. Meaning that not every employer offers the same if not any workers’ compensation. A full-time employee at a large company probably has workers’ compensation benefits. However, working as a contractor can pose the question of, “is the company they work for responsible for their injuries?” Some businesses sometimes don’t offer work injury insurance to any of their employees. Every situation is different and insurance companies can still fight a case. Whether or not your claim is valid, they may try to use evidence against you. To learn more about contractor benefits and regulations, click here.

Workers’ Compensation Claim Denied Because Of…

The insurance company is supposed to help but won’t give away money without clear evidence of a work injury. Insurance companies will only pay what THEY believe is fair. Therefore, depending on the severity of your injury, they may claim that you don’t have an injury, so you don’t need compensation. If alcohol or drugs were involved then they may report this to the state, leading to a claim denial. Moreover, if there is any speculation that the hurt employee intentionally hurt themselves, they may not receive compensation. So many possibilities. In the event that your claim is denied, what should you do next?

Workers’ Compensation Claim Denied Because Of…

Workers’ Compensation Claim Denied? Time To File An Appeal

If your claim was denied by your employer or their insurer, you have options. The first step is filing an appeal. You and your employer or their insurance will need to submit any issues and you will need to request a hearing with the commission of the state/territory that the claim was filed in. An appeal needs to be requested within 30 days of the decision in both Maryland and Washington D.C.. Once a hearing is scheduled, you and your employer and their insurance company will have a chance to prove their side. If the case is lost, you have 15 days from the date of decision to request a rehearing, in Maryland and D.C.. 

The rehearing decision is not automatic and could be denied. Most often they are only approved if you have new evidence or the commissioner made a legal mistake. If the rehearing is lost or the rehearing is denied, you can appeal to Circuit Court. In Maryland and Washington, D.C. there is 30 days from the date of the decision to file an appeal with the Circuit Court nearest to you. If that case is lost as well, depending on which state or territory you live in, you may have to file elsewhere. With all of these decisions and time constraints, you can receive proper help. A workers’ compensation attorney may be what you need. 

Is It Worth Hiring A Workers’ Compensation Attorney?

Filing in appeals court is time consuming. You need to be on top of deadlines and very organized. Even the most organized people would be overwhelmed by this process. The choice to hire an attorney is up to you. Hiring an attorney will take the burden off your shoulders and may ensure that every detail is handled correctly. For example, the request to file a hearing. 

The request may seem like a simple task but you will need to submit a formal written Request for Rehearing (in Maryland). With the right language and approach, an attorney can help prove your case. Hiring an attorney may also show that you’re serious about your claim.

Is It Worth Hiring A Workers’ Compensation Attorney?

The commission already believes you don’t have a work injury claim. They denied your case. Having a lawyer by your side may prove that you are serious and truly believe you’ve been injured on the job and deserve the right to compensation. If you are thinking about hiring an attorney, don’t wait any longer. There are deadlines to be met and recovery to be achieved.

Contact A Workers’ Comp. Attorney Before It’s Too Late

Contact A Workers’ Comp. Attorney Before It’s Too Late

If your work injury claim states: Workers’ Compensation Claim Denied, there is still hope. Believing you have a case is one aspect but doing something about it, can change the outcome of your situation. You need to make sure even the small tasks correct, that you are on time and, most importantly, that you get better. The whole reason you are probably reading this blog is because you have suffered a work injury. Make sure to take care of yourself. Contacting an attorney can improve your chances at compensation and give you faster recovery. The sooner you do, the better your outcome.