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Do I have options if my worker’s compensation claim is denied?

If you were injured at work, you may have expected that your claim for workers’ compensation benefits would be approved. It may have been shocking to discover your claim was actually denied, but an initial denial does not necessarily mark the end of the road for your claim.

Each situation is different, but if your workers’ compensation claim has been denied you may still have the option to appeal the denial. This can help you receive the benefits you are entitled to receive. However, you may need to act quickly to make the most of this opportunity.

Determine why your claim was denied

One of the first things you should do after learning of the denial is to carefully read over the denial letter. This letter should include a description of why your claim was denied.

Sometimes a claim is denied because of an error, such as a missed deadline or lost paperwork. Other times a claim may be denied because it may not be clear that your injury is job related. Understanding the reason for your claim’s denial can help you adequately address the denial reason, if you choose to appeal the decision.

Consider filing an appeal

If you decide to more forward with an appeal, you can begin the  process by filing a case at the Division of Workers’ Compensation district office in the county where you live or the county where you were injured. You must also serve the appropriate paperwork on the claims administrator and request a hearing.

During your hearing, a judge will try to help you and the claims administrator reach a fair settlement. If a settlement cannot be reached, your case may go to trial before another judge. If you disagree with this judge’s decision after trial, you can file a Petition for Reconsideration.

Workers’ compensation benefits are intended to offer protection to those who are injured while working, but not all claims are successful. If you believe your claim was denied in error, filing an appeal may be the best path toward receiving the benefits you deserve.

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Ozurovich & Schwartz
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