Employees who are injured on the job are entitled to workers' compensation benefits. You can be reimbursed for lost wages or medical bills. These benefits can pay part of your salary if you become temporarily or permanently disabled. If you can't sue your employer, these benefits may be your only choice. As a result, it is especially devastating if your claim is denied by your employer or insurance company.
If you receive a rejection after submitting your workers' compensation claim, you are entitled to receive some notification in the form of a letter detailing why their claim was rejected. There are two options on how you can proceed in such a situation. You can look for legal representation to pursue your case or you can appeal in person, requesting that your case be re-examined anew. In such a reconsideration submission, you need to add more evidence to strengthen your case. Otherwise, you might be slapped with a rejection once more. There is also a third option where some workers feel that they stand a much better chance if they ask for a hearing before an administrative law judge. In any case however, you need to provide additional documentation if your appeal claim is to stand any chance of success.
Disputing a rejected claim on your own is perfectly acceptable way to deal with the situation. However, there is a likelihood that such a claim will not pass through once more. This is the reason why looking for lawyer well versed in such procedural matters is the best cause of action.
There is a host of reasons why a claim can be rejected by the insurers. The key to success is coming into grips with the possibilities and therefore seeking for ways to avoid them. The possible reasons include:
* Lack of adequate evidence
* A physical exam was not performed.
* Claims that were filed too late
* There is a pre-existing condition.
* There is suspicion of fraudulent information in the claim
However, insurance companies sometimes do make mistakes and act in bad faith. For example, your workers' compensation claim may have been wrongfully denied because of a pre-existing condition. In fact, when an on-the-job illness or injury affects a pre-existing condition, most employees are entitled to benefits.
The following is a set of tips on what to do if your workers' compensation claim is denied unjustly:
1. Look for a specialist attorney in the area of workers' compensation law. Such a practitioner is well placed to re-negotiate with your insurance company to reconsider your application. This is because such attorneys are knowledgeable on all areas of labor laws and how they are applicable in your state. You do not need to have any money on the ready to retain such services: these lawyers will readily agree to take a certain percentage of the compensation payout when it is made.
2. Ask for a copy of your personnel file; it should contain the report you completed when you were injured. Send a copy to the insurance company as soon as possible and keep a copy for yourself.
3. Get evidence for your file. Include medical records, reports from your doctor, test results, emergency room reports, and rehabilitation progress reports on your injury and recovery. Be sure to get written statements from any witnesses. Also keep track of your personal medical expenses: transportation to doctor's appointments, prescription costs, etc.
4. Ensure that you attend the hearings in person. When it comes to detailing the extent of the injuries, expenses and the amount lost in earnings: ensure you tell the truth as supported by the evidence.
5. Every time the insurer communicates to you, refer the correspondence directly to your attorney. Do not make the mistake of responding yourself no matter how trivial the issue sounds.
6. Beware that the insurance company may follow you in public and take photographs and video of any evidence of you participating in some form of strenuous physical activity or another. They can then rightfully claim that your claim is fraudulent.
If you have suffered injury during the course of work, engaging the services of an adept workers' compensation attorney is the best option you have in seeking for a just recompense.
If you receive a rejection after submitting your workers' compensation claim, you are entitled to receive some notification in the form of a letter detailing why their claim was rejected. There are two options on how you can proceed in such a situation. You can look for legal representation to pursue your case or you can appeal in person, requesting that your case be re-examined anew. In such a reconsideration submission, you need to add more evidence to strengthen your case. Otherwise, you might be slapped with a rejection once more. There is also a third option where some workers feel that they stand a much better chance if they ask for a hearing before an administrative law judge. In any case however, you need to provide additional documentation if your appeal claim is to stand any chance of success.
Disputing a rejected claim on your own is perfectly acceptable way to deal with the situation. However, there is a likelihood that such a claim will not pass through once more. This is the reason why looking for lawyer well versed in such procedural matters is the best cause of action.
There is a host of reasons why a claim can be rejected by the insurers. The key to success is coming into grips with the possibilities and therefore seeking for ways to avoid them. The possible reasons include:
* Lack of adequate evidence
* A physical exam was not performed.
* Claims that were filed too late
* There is a pre-existing condition.
* There is suspicion of fraudulent information in the claim
However, insurance companies sometimes do make mistakes and act in bad faith. For example, your workers' compensation claim may have been wrongfully denied because of a pre-existing condition. In fact, when an on-the-job illness or injury affects a pre-existing condition, most employees are entitled to benefits.
The following is a set of tips on what to do if your workers' compensation claim is denied unjustly:
1. Look for a specialist attorney in the area of workers' compensation law. Such a practitioner is well placed to re-negotiate with your insurance company to reconsider your application. This is because such attorneys are knowledgeable on all areas of labor laws and how they are applicable in your state. You do not need to have any money on the ready to retain such services: these lawyers will readily agree to take a certain percentage of the compensation payout when it is made.
2. Ask for a copy of your personnel file; it should contain the report you completed when you were injured. Send a copy to the insurance company as soon as possible and keep a copy for yourself.
3. Get evidence for your file. Include medical records, reports from your doctor, test results, emergency room reports, and rehabilitation progress reports on your injury and recovery. Be sure to get written statements from any witnesses. Also keep track of your personal medical expenses: transportation to doctor's appointments, prescription costs, etc.
4. Ensure that you attend the hearings in person. When it comes to detailing the extent of the injuries, expenses and the amount lost in earnings: ensure you tell the truth as supported by the evidence.
5. Every time the insurer communicates to you, refer the correspondence directly to your attorney. Do not make the mistake of responding yourself no matter how trivial the issue sounds.
6. Beware that the insurance company may follow you in public and take photographs and video of any evidence of you participating in some form of strenuous physical activity or another. They can then rightfully claim that your claim is fraudulent.
If you have suffered injury during the course of work, engaging the services of an adept workers' compensation attorney is the best option you have in seeking for a just recompense.
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