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Was your workers' compensation claim denied?

If you've been hurt on the job, and you've read the laws on workers' compensation benefits, you might think that getting benefits to pay for your medical care is an easy, straightforward process -- and in many cases it is. However, in other cases, workers receive a denial of benefits.

Just the workers' compensation insurance company denied your claim for benefits doesn't mean you're out of luck. You might be able to file a successful appeal.

How to file an appeal for a workers' compensation claim

Maybe your entire claim was denied; maybe part of your claim denied; or, maybe you're not receiving the maximum amount of benefits you deserve. If you're not happy with the insurance company's decision on your workers' compensation claim, you might be able to file an appeal. Here's how to do it.

1. Figure out why the insurer denied your claim or why the insurer didn't award you the benefits you deserve. Here are some common reasons why an insurer denies a claim:

  • You failed to timely report your injury.
  • You failed to timely file your claim.
  • Your employer disputed your claim.
  • Your injury is not a compensable injury.
  • No medical treatment can help your situation.
  • Not enough evidence that your injury happened on the job.

2. Appeal the decision before the deadline. Your denial letter will list how long you have to file your appeal. Be sure to file your appeal as soon as possible and within this timeframe. Before filing the appeal, speak with the insurer and your employer to figure out if you can resolve the problem without filing an appeal.

3. Learn about workers' compensation law. Filing a workers' compensation appeal isn't necessarily easy and it pays to understand the law. These issues can be difficult for a novice to understand and navigate and you might want to seek out professional assistance.

4. Get your documentation in order. Your workers' compensation appeal will require your medical records, medical bill payment history and notes pertaining to your injury. Basically, gather any and all evidence regarding the circumstances of your injuries, the nature and extent of your injuries, your medical care, your continuing medical care, and -- if you can't work -- why you're not able to work at the moment.

Do you deserve workers' compensation benefits?

Chances are, if you got hurt in the course and scope of carrying out your job duties, you can get workers' compensation benefits. However, just because it's your legal right does not mean that you won't have to fight for your benefits and protect your legal rights in court.

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