The workers’ compensation system provides certain benefits to workers who are injured while on the job. In a similar way to your personal auto insurance, businesses pay premiums for workers’ compensation insurance that will provide medical and wage payments to the injured party and provide a layer of protection to the businesses themselves.
Like any insurance claim, the rules are complex. You have filed for benefits and your claim was denied. Meanwhile, your medical bills may be arriving and your income may be lost while you are off work. What now?
Why was my workers’ comp claim denied?
The most common reasons are:
- the injury didn’t occur while you were at work or performing a work-related task
- the injury was the result of a preexisting injury or condition
- if there is a dispute as to exactly when or where the injury occurred
- a health professional concluded that you aren’t disabled as a result of your work injury and are therefore still able to perform your work duties
- there is a dispute whether you sustained injuries at all
How can I appeal a denied workers comp claim?
While the exact methods of appealing the denial can vary among the states (unless you are a federal employee), there are a few things that everyone can do when seeking a review of a denied claim:
- Hire a workers’ compensation attorney to handle the appeals process.
- Don’t wait. In Ohio, you must file a formal appeal within 14 days of the receipt of the denial.
- Contact the BWC.
How can a Workers’ Compensation lawyer help me?
Workers’ compensation is all we do. As your lawyer, I will determine the reasons for the denial of your claim and gather documentary evidence, including contacting possible witnesses to your injury and retaining experts from the medical field as well as your work industry if needed.
Most workers’ comp claims are denied based on medical issues. I will have your injury or disability evaluated by an independent medical specialist and/or review your specific case with your present health care provider to determine if a more detailed medical report should be drafted. I will also determine if any additional proof is needed to demonstrate a disability or directly related injury.