Three Steps You Need To Take After A Workers’ Compensation Claim Denial

If you suffer an injury while working, a letter in the mail from your company’s insurance provider can feel like a blessing until you open it up and find out that they are denying your claim. You may have been counting on that claim to help offset lost wages or assist with medical expenses, and that denial can throw everything for a loop. At this moment, it’s important not to panic.

Instead, you need to take a breath, collect your thoughts and proceed with very specific intentions. In today’s blog, we explain the three steps you need to take if you find out that your workers’ compensation claim has been denied.

Three Moves To Make After A Claim Denial

It’s normal to feel anxious or nervous about your claim after receiving an initial denial, but this is more common than you may believe. Take a breath and then follow these three steps to help get your claim back on track.

1. Contact Your Lawyer – If you don’t have a lawyer, the first thing you need to do is to reach out to an attorney and find someone to help represent you during the claims process. They are experts in their field and have no problem going up against the insurance giants to get their clients what they deserve. Many people are initially hesitant to hire a lawyer because they think that it will only be another financial burden at a time when money may be getting tight, but that’s not the case. A workers’ compensation lawyer works on what’s known as a contingent basis, meaning they get paid a fraction of your winnings. Not only does this mean that you won’t have major up-front costs, but you’ll only be on the hook to settle up with your lawyer if they help you receive a big payday. Oftentimes they can more than pay for their services by getting you a much bigger award than you could get on your own. After a denial, hiring a lawyer is a must. If you already have a lawyer, you need to let them know that your claim has been denied.

2. Understand Why – When you’re connecting with your lawyer about the denial, odds are the conversation will center around the reason for the denial. In the letter you receive, there should be a space that indicates why your claim was denied. Make sure that you read and understand this section, as it will impact how you proceed. For example, if your claim was incomplete, all you may need to do is file the correct paperwork. However, if the insurance company is questioning the legitimacy of your claim or your doctor’s evaluation, you’ll have to counter the denial in a different manner. It is imperative that both you and your lawyer fully understand why it is that your claim was not approved by the insurance company.

3. Walk Away With A Plan – Finally, the last step involves developing a plan to rectify the situation. The exact steps will be determined on a case-by-case basis, but oftentimes the first two steps help to guide this third step. For example, if your claim was denied because of an issue with your medical exam, your lawyer can help direct you to a physician who can perform an independent medical exam to address any lingering medical issues. If there are questions about the credibility of your claim, you and your lawyer can workshop some ways to build a stronger claim. You can seek out video recordings of the accident, or pass along the contact information of any witness who can verify your story. There is no perfect playbook for this step, but you need to walk away from this conversation with a plan of action. If you’re still not sure what you can do to help your claim, ask your lawyer what you should be doing to help the process along.

Claim denials happen quite often, but they’re nothing that our team hasn’t successfully handled in the past. You shouldn’t have to navigate a denial on your own, and we’re confident that we can help you get the compensation that you deserve after an initial denial. For more information, or to check off all three steps on this list if you’ve received a claim denial, pick up the phone and call the Margolis Law Firm today at (952) 230-2700.