The process of appealing a denied workers’ compensation claim

On Behalf of | Dec 10, 2021 | Workers' Compensation

An injured North Carolina worker has the right to seek financial support through a claim with his or her employer’s workers’ compensation insurance. This coverage exists for the purpose of supporting employees who suffer injuries while working or become ill as a result of their job environment. Even if you have a valid reason to seek benefits, it is possible that your initial claim may come back denied. If this happens, you can move forward with an appeal.

The appeals process can be challenging, and it will be helpful for you to know what to expect from the required steps. If you wish to secure workers’ comp benefits after a denied claim, you have the right to keep fighting. Sufficient preparation will help you have a higher chance of success with your appeal, helping you secure necessary benefits in a timely manner.

Why the denial?

One of the most important things you can do before you move forward with your appeal is find out why your claim came back denied. Typically, this information is in the letter from the insurance company. Common reasons for claims to come back denied include:

  • The insurance company does not think your injury is compensable.
  • You did not report the injury in the required window of time or through the required channels.
  • There is not enough evidence that medical treatment was necessary for your injury.
  • You did not include enough evidence that the injury is a result of your job.

Injuries related to your work are more than an inconvenience. You may not be able to work during your recovery, and you could find yourself dealing with medical bills you cannot afford on your own. It is crucial to secure workers’ comp benefits for the purpose of replacement of your lost wages, coverage of your medical needs and more.

Where should you start?

If you received a denial letter from the workers’ compensation insurance provider, this is not the final word in your case. The appeals process allows you to take certain steps that provide you the opportunity to fight for the help you need and deserve. A denied claim is frustrating, but you could still secure what you require for a reasonable and fair recovery, as well as help returning to work.